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Background/aimsTo investigate the relationship between the foveal avascular zone (FAZ) parameters assessed by optical coherence tomography angiography (OCTA) and central visual field parameters in glaucoma and healthy subjects.MethodsOne hundred and eighty-eight subjects (248 eyes), including 24 healthy (38 eyes), 37 glaucoma suspect (42 eyes, and 127 primary open angle glaucoma (POAG) patients (168 eyes), underwent imaging using OCTA and standard automated perimetry using the 24-2 and 10-2 Swedish Interactive Thresholding Algorithm. OCTA-based and OCT-based FAZ parameters (superficial FAZ area, FAZ circumference), foveal vessel density (FD300) and foveal thickness were measured. The correlation between FAZ parameters and visual field parameters was assessed using linear mixed model.ResultsAxial length adjusted-FAZ area was not different among the three groups (mean (95% CI)): in healthy 0.31 (0.27 to 0.36) mm2, glaucoma suspect 0.29 (0.26 to 0.31) mm2and POAG eyes 0.28 (0.27 to 0.30) mm2(p=0.578). FD300 was lower in glaucoma suspect 49.1% (47.9% to 50.4%) and POAG eyes 48.7% (48.1% to 49.4%) than healthy eyes 50.5% (49.3% to 51.7%) though the difference was not statistically significant (p=0.071). Lower FD300 was associated with worse 24-2 and 10-2 visual field mean deviation and foveal threshold in multivariable linear mixed models (all pConclusionsThe FD300, but not the FAZ area was correlated with 10° central visual field mean deviation and foveal threshold in healthy, glaucoma suspect and POAG eyes. In contrast, a smaller FAZ area was associated with lower IOP.

Purpose Genetic testing is frequently conducted on people with intellectual disability. This systematic literature review sought to assess what research has been conducted with people with intellectual disability to investigate their opinions and experiences of genetic counselling and testing. Methods Search of five online databases (from year of database creation to 2021) yielded 1,162 articles. Seven articles met the inclusion criteria. We assessed the quality, accessibility and inclusivity of each study and extracted the data. Deductive content analysis was performed. Results Most study participants demonstrated both the desire and the capability to learn more about genetic conditions and genetic tests. Participants expressed a wide variety of opinions about genetic tests, similar to the range of opinions of the general population. All studies were small, from a limited number of countries, and analysis showed limited evidence of inclusivity or accessibility. Conclusions This review highlights major gaps in understanding of the opinions, experiences, and preferences of people with intellectual disability regarding genetic counselling and testing. There is urgent need for research to co-design a more inclusive genomic model of care to address this failure in healthcare accessibility and equity.

PURPOSE: To characterize the change of ganglion cell complex (GCC) thickness and macula vessel density in eyes diagnosed as being glaucoma suspect eyes with ocular hypertension (OHT) or glaucomatous optic neuropathy (GON). DESIGN: Prospective, longitudinal study. PARTICIPANTS: 83 eyes (24 healthy eyes, 30 OHT eyes, and 29 GON eyes) of 65 subjects who had at least 3 visits were included from the Diagnostic Innovations in Glaucoma Study. The mean follow-up was at least 3 years. METHODS: Optical coherence tomography angiography (OCTA)-based vessel density and OCT-based structural thickness of the 3×3 mm(2) GCC scan slab were evaluated at each visit. The rates of vessel density and thickness change were compared across diagnostic groups using linear mixed-effects model. MAIN OUTCOME MEASURES: Change rates of macula GCC thickness and superficial macula vessel density. RESULTS: Significant mean rates of both GCC thinning and macula vessel density loss were detectable in OHT and GON groups. 49.1% of the individual suspect eyes showed significant loss (P0.2). Higher mean intraocular pressure during follow-up was associated with a faster rate of GCC thinning in the OHT group (P=0.065) and GON groups (P=0.015), but was not associated with the rate of vessel density decrease. CONCLUSIONS: While the rate of GCC thinning was faster on average in suspect eyes than in healthy eyes, some suspect eyes had significant loss of vessel density and faster vessel density loss than GCC thinning. OCT and OCTA are complementary and useful for evaluating eyes with OHT or GON.

Postoperative nutrition support is an essential component of management in upper gastrointestinal (UGI) cancer resection, however there is limited knowledge of current clinical practice. This study aimed to describe the postoperative nutrition support received by patients undergoing UGI cancer resections, assess adherence with ESPEN surgical guideline recommendations, and to investigate differences between oesophageal, gastric and pancreatic surgeries. The secondary aim was to explore the association of adherence with ESPEN guidelines and provision of nutrition support, with surgical complications and length of stay (LOS).The NOURISH point prevalence study was conducted between September 2019-June 2020 across 27 Australian tertiary centres. Malnutrition was diagnosed using subjective global assessment. Data on postoperative diet codes, prescription of nutrition support (oral (ONS), enteral (EN), parenteral (PN)) and nutritional adequacy were collected by dietitians for the first 10 days of admission. Fisher's exact test was used to determine differences in nutritional management and adherence to ESPEN guidelines between surgery types. Multivariate regression analysed associations with surgical outcomes.Two-hundred participants were included (42% pancreatic, 33% oesophageal, 25% gastric surgery). Overall, only 34.9% (n = 53) met the guideline recommendations that were applicable to them. Early oral intake of fluids or solids (within 24 h post surgery) was initiated for 23.5% (n = 47), whilst ONS/EN/PN was initiated for 49.5% (n = 99). Only 25% of pancreatic surgeries had nutrition support initiated on the first postoperative day compared to 86.4% of oesophageal and 42.0% of gastric surgeries (p 0.001). In those who were 'nil by mouth', EN/PN were commenced within 24 h for 51.0% (n = 78), with 18.5% and 45.2% for pancreatic and gastric surgeries compared to 86.0% in oesophageal surgeries (p 0.001). In malnourished patients, 35.7% (n = 30) commenced EN within 24 h, with 11.1% and 31.8% for pancreatic and gastric compared to 73.1% in oesophageal surgeries (p 0.001). For patients meeting60% energy/protein requirements for ≥7 days, only 14.8% (n = 9) received EN/PN, with 2.5% and 16.7% of pancreatic and gastric compared to 75.0% of oesophageal surgeries (p 0.001). The number of days spent 'nil by mouth' or 'clear fluids' without EN/PN, as well as number of days with60% estimated requirements met were independently associated with increased LOS and complications.Overall, there was poor adherence to the majority of assessed ESPEN guidelines, and care for patients undergoing pancreatic and gastric surgeries was less compliant than oesophagectomy. Poor nutritional adequacy was associated with increased LOS and complications. There is a clear need for knowledge translation and implementation studies to increase adherence to evidence-based recommendations in the Australian setting supported by an understanding of barriers and enablers to optimal postoperative nutrition management.

Aim: Study aims to assess amylase, lipase of patients with Type 2 diabetes under different types of treatments. Materials & methods: Patients’ treatment modalities including insulin, metformin, pioglitazone, sodium-glucose co-transporter-2 inhibitors, insulin secretagogues, dipeptidyl peptidase-4 inhibitors and glucagon like peptide-1 receptor agonists were compared. Results: There was no difference in amylase and lipase levels between dipeptidyl peptidase-4 inhibitor users and non-users (p = 0.2, p = 0.3, respectively) and glucagon like peptide-1 analog users and non-users (p = 0.1, p = 0.7, respectively). Patients who use insulin secretagogues had significantly higher amylase, lipase (77.2 ± 39.8 vs 69.5 ± 33.0, p = 0.038 and 47.2 ± 33.2 vs 39.6 ± 26.8, p = 0.01, respectively) and patients on basal insulin had lower amylase levels (69.9 ± 37.7 vs 77.2 ± 33.7, p = 0.014). Conclusion: Incretin-based therapies showed no difference in amylase and lipase levels whereas there was increase with secretagogues and decrease with basal insulin.

Introduction: Although psoriasis and obstructive sleep apnea syndrome (OSAS) are associated with systemic inflammation, studies on their potential bilateral relationship are not sufficient. Aim: To investigate vitamin D levels and receptor gene polymorphisms in patients with OSAS and psoriasis and the associations with these diseases. Material and methods: One hundred thirty-seven patients included in the study consisted of 4 different groups: group 1, those with both diseases; group 2, those with OSAS only; group 3, patients with psoriasis only; and group 4, healthy controls. The patients??? serum calcium, phosphorus, AHI, Epworth Sleepiness Scale, Psoriasis Area Severity Index, and VDR TagI, ApaI, BsmI polymorphisms were compared. Results: Vitamin D levels of groups 1, 2 and 3 were found to be lower than in controls. There was no statistically significant correlation between VDR TagI, ApaI, BsmI gene polymorphisms of the groups. Vitamin D levels were significantly higher in patients with heterozygous ApaI genotype (A/C) compared to patients with normal (A/A) or homozygous mutant (C/C) genotype (p < 0.05). No relationship was determined between VDR TagI, ApaI, BsmI, and the other parameters. Conclusions: In our study, 1,25(OH)2-vitamin D3 levels were significantly lower in all disease groups compared to the control group. Although there is no difference between the groups in terms of VDR gene polymorphism, we think that there may be a bidirectional relationship between these diseases based on the low vitamin D levels. Namik Kemal University Scientific Research Projects Coordination Unit [NKUBAP.02, 18.188] A this study was supported by Namik Kemal University Scientific Research Projects Coordination Unit (Project Number NKUBAP.02.GA.18.188).

The aim of this prospective study was to investigate associations between nasal/oropharyngeal structures and a range of factors including age, gender, daytime sleepiness, and body mass index (BMI). Patients with OSA were prospectively selected as research participants in rhinomanometric analysis as well as for otolaryngological evaluation. Participants were grouped as follows according to their apnea/hypopnea index (AHI) scores: no OSA (AHI

Amaç: Sığır yetiştiriciliğinde Pasteurella multocida ve Mannheimia haemolytica’nın sebep olduğu pnömoniler yol açtıkları ekonomik kayıplar nedeniyle oldukça önemlidir. Bu çalışmada mikrobiyolojik yöntemler ve real time PCR ile P. multocida ve M. haemolytica'nın neden olduğu belirlenen pnömonili sığır akciğerlerinde ve nasal swaplarda belirlenen sitolojik bulguların ortaya konulması amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada sığır pnömonik akciğerlerinde bakteriyolojik kültür, histopatolojik, sitolojik ve real time PCR teknikleri kullanıldı. Real time PCR ile M.haemolytica ve P.multocida belirlenen pnömoni olgularında sitolojik bulgular değerlendirilerek diğer pnömoni tipleri ile karşılaştırıldı. Bulgular: Burun swap ve akciğer örneklerinden hazırlanan smear örneklerinde sitolojik bulgular kaydedildi. Pnömoni belirtisi görülen 233 sığırın 23’ünde (%9.87) P.multocida ve M. haemolytica’ya bağlı pnömoni belirlendi. Fibrinli bronkopnömonili hayvanlar içerisinde yaklaşık % 51,11’inde P.multocida ve M.haemolytica olduğu belirlendi. Bu olguların sitolojik incelemelerinde diğer pnömonilere kıyasla nötrofil lökosit sayısının arttığı tespit edildi. Nötrofillere ilave olarak; P.multocida ve M.haemolytica belirlenemeyen diğer fibrinli bronkopnömoni olgularıyla karşılaştırıldığında bu olgularda lenfosit ve silialı epitel hücrelerin sayısının önemli derecede arttığı belirlendi. Öneri: Çalışmanın sonuçları Pasteurella multocida ve Mannheimia haemolytica’nın sebep olduğu pnömonilerin sığır solunum sistemi enfeksiyonlarının önemli bir bölümünü oluşturduğunu ve fibrinli pnömoniye neden olduğunu göstermiştir. Elde edilen sitoloji sonuçları pnömonilerin tiplendirilmesinde klinik olarak değerlendirilebilir., Aim: In cattle breeding, pneumonia caused by Pasteurella multocida and Mannheimia haemolytica is very important due to the economic losses caused. In this study, it was aimed to reveal cytological findings in pneumonic bovine lungs and nasal swaps due to P. multocida and M. haemolytica determined by microbiological methods and real time PCR. Materials and Methods: In this study, bacteriological culture, histopathological, cytological and real time PCR techniques were used in pneumonic bovine lungs. Cytological findings were evaluated in cases of pneumonia whose etiological agent was identified as M.haemolytica and P.multocida by real time PCR and were compared with other pneumonia types Results: Cytological findings were recorded in smear samples prepared from nasal swaps and lung samples. Pneumonia caused by P. multocida and M. haemolytica was detected in 23 cases (9.87%) out of 233 cattle with signs of pneumonia. P.multocida and M.haemolytica were determined to occur in about 51.11% of the animals with fibrinous pneumonia. During the cytological examination of these cases, neutrophils were seen increased in number compared to the other types of pneumonia. In addition to neutrophils, the number of lymphocytes and ciliated epithelial cells was also significantly increased in these cases compared to the other fibrinous pneumonia cases in which P.multocida ve M.haemolytica was not detected. Conclusion: The results of this study showed that P. multocida and M. haemolytica cause a fibrinous type of pneumonia and constitute an important portion of cattle respiratory diseases. Clinically, cytology results may be evaluated for the typing of pneumonia.

BACKGROUND We aimed to compare the clinical and laboratory characteristics and imaging methods of patients diagnosed with preseptal cellulitis and orbital cellulitis in the pediatric age group. METHODS The study was designed retrospectively, and the medical records of all patients who were hospitalized with the diagnosis of preseptal cellulitis and orbital cellulitis were reviewed. The findings of preseptal cellulitis and orbital cellulitis groups were compared. The risk factors for the development of orbital involvement were analyzed. RESULTS A total of 123 patients were included, 90.2% with preseptal cellulitis and 9.8% with cellulitis. The male gender ratio was 60.2%, and the mean age was 72 ± 43 months. While all patients had eyelid swelling and redness, 20.3% had fever. Ocular involvement was 51.2% in the right eye and 4.9% in both eyes. The most common predisposing factor was rhinosinusitis (56.1%). Radiological imaging (computed tomography/magnetic resonance imaging) was performed in 83.7% of the patients. Subperiostal abscess was detected in 7 cases (5.6%) in which three of the cases were managed surgically and four were treated with medically. The levels of C-reactive protein were significantly higher in patients with orbital involvement (P = 0.033), but there was no difference between the presence of fever, leukocyte and platelet values. CONCLUSIONS Rhinosinusitis was the most common predisposing factor in the development of preseptal cellulitis and orbital cellulitis. Orbital involvement was present in 9.8% of the patients. It was determined that high C-reactive protein value could be used to predict orbital involvement.

In this study the authors' investigated the effect of group education on human papillomavirus (HPV) on level of knowledge and health beliefs for HPV infection and vaccine. The study was semi-experimental with a pre- and post-test education model. In total, 110 mothers of secondary school students, 55 in education group, and 55 in control group participated. The groups were educated on different content and three evaluations (pre-education, post-education, and six months following the education) were made. HPV knowledge and belief scores of the education group increased compared to pre-education and control group scores (

Among age-related diseases, the incidence of cancer increases significantly due to the overlap of some molecular pathways between cancer and aging. While the genetic influence on the human lifespan is estimated to be about 20-25%, epigenetic changes play an important role in modulating individual health status, aging. Aging and age-related conditions are processes that can be modified by both genetic, environmental factors, including dietary habits. Epigenetics is a new discipline has significant potential to be applied for the prevention, management of certain carcinomas and diseases. Epigenetic modifications may play an important role in disease occurrence and pathogenesis. Some nutritional components can be significantly effective in the prevention of breast, skin, esophagus, colorectal, prostate, pancreatic, lung cancers. It contains minerals, vitamins, and some bioactive components (curcumin, indole 3 carbinol, di-indolylmethane, sulforaphane, epigallocatechin-3-gallate, genistein, resveratrol, pterostilbene, apigenin, etc.) regulatory processes. However, compelling evidence suggests that dietary habits can manipulate the aging process and/or its consequences, have health benefits. Aging processes become complex when combined with the relational role of bioactive nutritional components on gene expression. In this review, the relationship between epigenetic processes caused by DNA methylylation, histone modification, non-coding m-RNA, and telomerase activity, the risk of aging and cancer is discussed.

Background/aim: Allergic bronchopulmonary aspergillus (ABPA) is a lung disease caused by hypersensitivity from Aspergillus fumigatus. Diagnostic criteria, staging systems and treatment methods for ABPA disease have been reported in studies evaluating populations, the majority of which are adult patients. Our study aimed to discuss the use of ABPA diagnostic criteria in children, the success of other alternative regimens to oral corticosteroids in the treatment of ABPA, and the changes that occur during treatment, in the light of the literature. Materials and methods: Between January 2017 and 2020, patients diagnosed with ABPA at the Dokuz Eylul University Child Allergy and Immunology clinic were identified; demographic characteristics, clinical and laboratory findings, diagnostic scores and stages, and treatment protocols were analyzed retrospectively. Results: The mean age of patients diagnosed with ABPA was 14.33 +/- 1.96. At the time of ABPA diagnosis, the median total IgE level was 1033 IU/mL (1004-6129), and the median AF specific IgE was 10.64 (2.59-49.70) kU/L. Bronchiectasis was detected in HRCT of 5 cases. We detected significant improvement in spirometric analysis with omalizumab treatment in our patient with steroid-related complications. Conclusion: Today, although risk factors have been investigated for ABPA, it has not been revealed clearly. Both diagnostic criteria and treatment regimens have been described in research studies, mostly adults. In pediatric patients; clarification of diagnosis and treatment algorithms is necessary to prevent irreversible lung tissue damage and possible drug side effects.

Autism spectrum disorder is a serious neurodevelopmental disease that affects social communication and behavior, characterized by an increasingly common immune mechanism and various complications in the gastrointestinal system. Symptoms of autism can generally vary according to the genetic background of the individuals, the environment in which they live. The microbiota of individuals with autism is also different from healthy individuals. Recently, probiotics, prebiotic, fecal microbiota transplantation, diet therapy, etc. options have come to the fore. Cofactors are even more important at this stage. Since it is related to the gut microbiota, immune mechanism, gastrointestinal system, attention has been drawn to the relationship between dysbiosis, autism in the intestine. The component of the gut microbiota in individuals with autism has been linked with gastrointestinal symptoms that develop with autism severity. However, the role of the microbiota in diagnosis, follow-up, treatment is not clear yet, and its two-way relationship with the nervous system makes it difficult to establish a cause-effect relationship. Nutritional cofactors required in neurotransmitter synthesis and enzyme activation must be regularly and adequately taken to maximize brain functions in autistic individuals. Therefore, this study was conducted to investigate the cause-effect relationship of ASD with microbiota and brain-gut axis, probiotic-prebiotic use.

Objective: To evaluate the possible associations between serum Neprilysin (NEP) levels and preeclampsia and mild and severe preeclampsia subgroups. Materials and methods: Fifty -five consecutive women with mild preeclampsia and fifty -five consecutive women with severe preeclampsia were compared with 110 approximately gestational age-matched (+/- 1 week) women with an uncomplicated pregnancy. Results: Mean serum NEP was significantly higher in women with preeclampsia compared to that of the gestational age-matched-controls (231.62 +/- 65.30 pg/mL vs. 187.75 +/- 84.38 pg/mL, p < 0.001). Mean serum NEP was significantly higher in the mild preeclampsia group compared to its gestational age -matched control group (228.84 +/- 67.26 pg/mL vs. 186.14 +/- 85.09 pg/mL, p = 0.008); and in the severe preeclampsia group compared to its gestational age-matched control group (234.45 +/- 63.85 pg/mL vs. 189.29 +/- 84.59 pg/mL, p = 0.004). Serum NEP was positively correlated with systolic and diastolic blood pressure, BUN, uric acid, and creatinine. Conclusion: Mean serum NEP was significantly higher in women with preeclampsia than women with an uncomplicated pregnancy. Further studies are needed to elucidate the possible therapeutic role of NEP inhibitors to treat preeclampsia. (c) 2021 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Istanbul Cerrahpasa University, Istanbul, Turkey; Carl von Ossietzky University Oldenburg, University Hospital for Obstetrics and Gynecology in Klinikum Oldenburg AoEuroR, Oldenburg, Germany This study was financed by Istanbul Cerrahpasa University, Istanbul, Turkey, and Carl von Ossietzky University Oldenburg, University Hospital for Obstetrics and Gynecology in Klinikum Oldenburg AoEuroR, Oldenburg, Germany.

Background: Every year, lung cancer contributes to a high percentage deaths in the world. Early detection of lung cancer is important for its effective treatment, and non-invasive rapid methods are usually used for diagnosis. Introduction: In this study, we aimed to detect lung cancer using deep learning methods and determine the contribution of deep learning to the classification of lung carcinoma using a convolutional neural network (CNN). Methods: A total of 301 patients diagnosed with lung carcinoma pathologies in our hospital were included in the study. In the thorax, Computed Tomography (CT) was performed for diagnostic purposes prior to the treatment. After tagging the section images, tumor detection, small and non-small cell lung carcinoma differentiation, adenocarcinoma-squamous cell lung carcinoma differentiation, and adenocarcinoma-squamous cell-small cell lung carcinoma differentiation were sequentially performed using deep CNN methods. Result: In total, 301 lung carcinoma images were used to detect tumors, and the model obtained with the deep CNN system exhibited 0.93 sensitivity, 0.82 precision, and 0.87 F1 score in detecting lung carcinoma. In the differentiation of small cell-non-small cell lung carcinoma, the sensitivity, precision and F1 score of the CNN model at the test stage were 0.92, 0.65, and 0.76, respectively. In the adenocarcinoma-squamous cancer differentiation, the sensitivity, precision, and F1 score were 0.95, 0.80, and 0.86, respectively. The patients were finally grouped as small cell lung carcinoma, adenocarcinoma, and squamous cell lung carcinoma, and the CNN model was used to determine whether it could differentiate these groups. The sensitivity, specificity, and F1 score of this model were 0.90, 0.44, and 0.59, respectively, in this differentiation. Conclusion.: In this study, we successfully detected tumors and differentiated between adenocarcinoma- squamous cell carcinoma groups with the deep learning method using the CNN model. Due to their non-invasive nature and the success of the deep learning methods, they should be integrated into radiology to diagnose lung carcinoma.

Klinik olarak canine distemper virüs (CDV) teşhisi konulan köpeklerde enfeksiyonun hem sürüntü örneklerinde ve hem de postmortem alınan doku örneklerinde hızlı teşhisine yönelik real-time RT-PCR metodu çalışılarak, viral nükleik asit tespitine dayalı real-time RT-PCR metodu ile histopatolojik yöntemin karşılaştırması amaçlanmıştır. Çalışmanın materyalini, ateş, gözyaşı akıntısı ile solunum, sindirim ve sinir sistemi enfeksiyonlarına ait klinik bulgulara sahip, CDV enfeksiyonu klinik tanısı ile tedaviye başlanmış, ancak tedaviye yanıt vermeden ölen köpeklerden histopatolojik bulgulara göre CDV teşhisi konulmuş köpeklere ait beyin, beyincik, karaciğer, akciğer, dalak, böbrek, taban yastığı ve kan ile tonsil, burun ve gözden alınan sürüntü örnekleri oluşturdu. Histopatolojik incelemelerde CDV enfeksiyonu için karakteristik sayılan intrasitoplazmik ve intranükleer inklüzyon cisimciği belirlenen köpeklerden nekropsi sırasında alınmış sürüntü örneklerinde viral nükleik asit varlığı incelendiğinde tonsillerden alınan sürüntülerin tamamında, burun ve konjunktivadan alınan örneklerin iki tanesinde CDV nükleik asit kopyalarının belirlendiği, kan örneklerinde ise viral nükleik asit belirlenemediği görüldü. Köpeklerde görülen klinik bulgular hastalığı düşündürse de kesin teşhis için kullanılan virolojik ve histopatolojik incelemeler uzun zaman almaktadır. Bu durum viral nükleik asitlerin çoğaltılması esasına dayalı PCR yöntemlerini ön plana çıkarmakta, PCR yöntemleri içerisinde de uygulayıcı hatasını minimize eden, hızlı sonuç veren ve virüs sayısının tahmin edilebildiği real-time RT-PCR uygulamalarının önemini artırmaktadır.

BackgroundIn migraine, there is no anatomical correlate of vertigo and no structural abnormality is evident in conventional imaging. Cervical vestibular-evoked myogenic potential (cVEMP) is an uncrossed inhibitory vestibulo-spinal reflex (VSR), while ocular VEMP (oVEMP) represents a crossed excitatory vestibulo-ocular reflex (VOR).ObjectiveThis study aims at functional evaluation of the findings of cVEMP and oVEMP in migraine patients.Material and methodsThis was a cross-sectional case-control study that included 20 migraine patients as the case group and 30 healthy adult subjects as a control group. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cVEMP, oVEMP, and posturography tests.Results35% of migraine patients showed delayed cVEMP latency and 40% showed abnormal oVEMP in the form of statistically significant delayed right oVEMP P1 (p = 0.050) and left oVEMP N1 latency (p = 0.038) compared with controls. cVEMP parameters were not correlated to posturography results. The majority of migraine patients (70%) had normal equilibrium pattern and normal sensory analyses ratios (65%). Only 30% had vestibular dysfunction.ConclusionsVSR and VOR are affected in migraine patients. We recommend the use of cVEMP and oVEMP in migraine patients for functional assessment of brainstem pathways.

This study was planned to determine the muscle architecture (pennation angle, muscle fiber length, and muscle thickness) and its relationship to lower extremity muscle strength in patients with Multiple Sclerosis (pwMS). The muscle architecture (pennation angle, muscle fiber length, and muscle thickness) and lower extremity muscle strength were assessed in 33 pwMS [13 Relapsing–Remitting MS (RRMS), 5 Primary Progressive MS (PPMS), 5 Secondary Progressive MS (SPMS), and 11 matched healthy controls (HC)]. Muscle architecture features were assessed with ultrasonography and muscle strength were assessed with a digital hand-held dynamometer. The rectus femoris muscle thickness and pennation angle, gastrocnemius muscle thickness, and the tibialis anterior pennation angle were significantly lower in pwMS compared to HC (p

Objective: Major Depressive Disorder (MDD) is a major health problem worldwide. Estrogen interacts with the central nervous system and has been shown to affect anxiety and depressive behavior. Estrogen mediates its effects by connecting its receptors, estrogen receptors 1 and 2. The purpose of this case-control study was to clarify the association between MDD risk and estrogen receptor 1 (ESR1) gene variants. Methods: This study included 245 individuals (125 MDD patients and 120 healthy controls). Polymerase Chain Reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP) technics were used for genotypingESR1XbaII (rs9340799) and PvuII (rs22346939) variants. Results: There were statistically significant differences between the groups in terms of genotype frequencies of the ESR1PvuII (-397 T > C) variant (p = 0.049) but not for the XbaII (-351 A > G) variant (p > 0.05). However, a correlation was observed between MDD and ESR1XbaII variant after male participants were excluded (p = 0.028). Also, the high pain score of MDD patients was associated with the ESR1PvuII variant, especially in female patients (p = 0.021). According to the results of combined genotype analysis, AA-TC combined genotype was correlated with a decreased risk in patients with MDD compared to controls (p = 0.016), while the combined genotype of GGCC was associated with increased risk in the patients with MDD compared to controls (p = 0.042). Conclusion: The two ESR1 variants were associated with MDD risk and its features in both individual and combined forms.

Objective: To evaluate the possible associations between serum 25-hydroxy vitamin D levels and clinical and laboratory parameters in endometriosis.Study design: A total of 53 women with endometriosis and 37 women without endometriosis were evaluated in a, case-controlled study. The demographic features, clinical, and laboratory parameters of the two groups were compared.Results: The serum 25-hydroxy vitamin D levels were significantly decreased in both stage 1-2 and stage 3-4 groups compared to the controls (p

Background Behçet’s disease (BD), a chronic systemic vasculitis, has distinct geographical and ethnic variation. Data regarding the epidemiology of patients with BD in the U.S. are limited; therefore, we sought to describe BD patient characteristics and medication use in the U.S., and compared them with data from patients from endemic regions. Methods We conducted a cross-sectional study using data from the RISE registry (2014–2018). Patients aged ≥ 18 years with BD were included. Sociodemographic and treatment information was extracted. We compared patients from the RISE registry to data from other published studies of patients with BD from endemic areas. Results One thousand three hundred twenty-three subjects with BD from the RISE registry were included. Mean age was 48.7 ± 16.3 years, female to male ratio was 3.8:1, and 66.7% were White. The most frequently used medications included glucocorticoids (67.6%) and colchicine (55.0%). Infliximab and adalimumab were the most used biologics (14.5% and 14.1%, respectively); 3.2% of patients used apremilast. The RISE registry had more women (79.3%), and patients were older compared to previously published BD studies from endemic areas. Methotrexate and TNFi were more commonly reported in RISE (21.8% and 29.4%) compared to studies from Egypt and Turkey. Colchicine, cyclosporine, and cyclophosphamide were more commonly used in cohorts from Egypt, Turkey, and Iran. Conclusions Findings from the largest BD dataset in the U.S. suggest that BD patients are predominantly female. Further research is needed to explore the reasons for the higher prevalence of BD among women in the U.S. and its possible impact on disease severity and management.

Background The impact of early diagnosis of fetal cardiac abnormalities on the postnatal outcome has been controversial in literature. We aimed to evaluate the role of fetal echocardiography (FE) as a diagnostic tool for early detection and proper management of fetal cardiac abnormalities, study the indications of referral and detect the perinatal outcome in our institution. Results This is a cross-sectional observational and descriptive study that included one hundred and one singleton pregnant women (101 fetuses) who were referred for FE over a period of one year. Indications for referral and perinatal risk factors were documented. FE and postnatal transthoracic echocardiography were done. Fetal cardiac abnormalities were detected in 46.5% of cases. Congenital heart defects (CHDs) in 34.6%, fetal arrythmias in 9.9%, cardiomyopathy in 2.9% and cardiac mass (Rhabdomyoma) in 1% (combined structural and rhythm abnormalities were observed in two fetuses). Of the CHDs, complex heart lesions were diagnosed in 57.1%, common atrioventricular canal in 28.6% and conotrunchal anomalies in 14.3%. Of the ten cases with fetal arrythmias, five fetuses had tachyarrhythmias, four had ectopics and one fetus had congenital heart block in association with maternal lupus. The indications for referral were abnormal obstetric ultrasound (52.5%), maternal medical illnesses (23.8%), multiple neonatal deaths (13.9%) and positive family history of CHD (10.9%). The number of fetuses with cardiac abnormalities was significantly higher than those without cardiac abnormalities in mothers not exposed to perinatal risk factors (p = 0.009) and was statistically lower in mothers exposed to perinatal risk factors (p = 0.005). FE showed 100% accuracy in diagnosing complex lesions, common atrio-ventricular canals, cono-truncal anomalies, cardiac masses and fetal arrhythmias. It missed two cases of tiny muscular ventricular septal defects and one case of aortic coarctation. Cases of fetal supraventricular tachycardia were successfully treated in-utero. Conclusions CHDs exist in fetuses with no underlying perinatal risk factors. FE can accurately diagnose most of the cardiac anomalies though few errors remain challenging (aortic coarctation). It also offers a good chance for successful early life-saving management of some types of fetal arrhythmia.

Objectives: the aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children.Methods: a retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: there were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4 degrees C (38.0-38.7 degrees C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: to the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution., NA

Aims: Molecular heterogeneity of breast cancer results in variation in morphology, metastatic potential and response to therapy. We previously showed that breast cancer cell line sub-groups obtained by a clustering approach using highly variable genes overlapped almost completely with sub-groups generated by a drug cytotoxicity-profile based approach. Two distinct cell populations thus identified were CSC(cancer stem cell)-like and non-CSC-like. In this study we asked whether an mRNA based gene signature identifying these two cell types would explain variation in stemness, EMT, drug sensitivity, and prognosis in silico and in vitro. Main methods: In silico analyses were performed using publicly available cell line and patient tumor datasets. In vitro analyses of phenotypic plasticity and drug responsiveness were obtained using human breast cancer cell lines. Key findings: We find a novel gene list (CNCL) that can generate both categorical and continuous variables corresponding to the stemness/EMT (epithelial to mesenchymal transition) state of tumors. We are presenting a novel robust gene signature that unites previous observations related either to EMT or stemness in breast cancer. We show in silico, that this signature perfectly predicts behavior of tumor cells tested in vitro, and can reflect tumor plasticity. We thus demonstrate for the first time, that breast cancer subtypes are sensitive to either Lapatinib or Midostaurin. The same gene list is not capable of predicting prognosis in most cohorts, except for one that includes patients receiving neo-adjuvant taxene therapy. Significance: CNCL is a robust gene list that can identify both stemness and the EMT state of cell lines and tumors. It can be used to trace tumor cells during the course of phenotypic changes they undergo, that result in altered responses to therapeutic agents. The fact that such a list cannot be used to identify prognosis in most patient cohorts suggests that presence of factors other than stemness and EMT affect mortality. This work was partially funded by a grant from the Turkish Scientific and Technological Research Council/TUBITAK (117S058) to AOG and one from The Higher Education Commission of Pakistan to MWA.

Buried bumper syndrome (BBS) is a rare and serious complication of percutaneous endoscopic gastrostomy (PEG) tube placement. In the literature, BBS is considered to be a late complication of PEG procedure, but it may occur in the early period after PEG tube placement. Early diagnosis and proper treatment are important. Different treatment modalities may be used to treat BBS. The aim of this study was to evaluate patients with BBS. During a time frame between January 2015 and February 2020, a hospital medical database was screened for PEG placement and BBS. Buried bumper syndrome was found in 36 patients. Demographic and clinical characteristics of these patients were retrospectively investigated. Those who developed BBS in the first month were evaluated as early BBS. Those who developed BBS after more than a month were evaluated as late BBS. The median BBS development time was 135.9 ± 208.1 days (9-834 days). In 18 (50%) patients, BBS developed within the first month. Serious complications such as abscess and peritonitis were observed in 8 (22.2%) patients on admission. Thirty-two (88.9%) of 36 patients were treated with external traction and four patients were treated with surgery. No complications were observed in patients who were treated with traction. Five patients died, of whom three of them died because of BBS complications, whereas two of them died from other causes unrelated to BBS. Buried bumper syndrome is a complication that can be seen in the early period after gastrostomy. External traction is a reliable method for treating these patients. Proper education of patients' relatives and caregivers is very important to prevent BBS and related complications.

BACKGROUND Children diagnosed with autism spectrum disorder (ASD) may have great difficulties when their routines change, and this may affect the psychological well-being of their parents. For this reason, it is important to examine studies that address the mental health of parents in order to adapt to the coronavirus disease 2019 (COVID-19) pandemic. AIM To determine the mental health status of parents with children diagnosed with ASD in the COVID-19 pandemic. METHODS The study, which is a systematic review, was conducted between December 15, 2020 and December 30, 2020 by scanning articles in English. The Scopus, Science Direct, PubMed, Cochrane, Web of Science, and Google Scholar databases were used for scanning. The keywords COVID-19 AND (“autism” OR “autistic” OR “autism spectrum disorder”) AND parent AND (“mental health” OR “anxiety” OR “stress”) were used in the search process. The inclusion criteria in the study were findings regarding the mental health of parents with children diagnosed with ASD in the COVID-19 pandemic, addressing their anxiety and stress situations, being a research article, and accessing the full text of the article. RESULTS In the study, a total of 6389 articles were reached, and the full texts of 173 articles were evaluated for eligibility. After the articles excluded by the full-text search were eliminated, 12 studies involving 7105 parents were included in the analysis. The findings obtained from the articles containing data on mental health in the COVID-19 pandemic of parents with children with autism spectrum disorder were discussed in three groups. These were findings on the experiences of parents with children with ASD in the COVID-19 pandemic regarding the areas where parents with children with ASD need support in the COVID-19 pandemic and methods of coping with the COVID-19 pandemic for parents with children with ASD. In the systematic review, it was determined that the anxiety and stress of the parents increased, they needed more support compared to the pre-pandemic period, and they had difficulty coping. CONCLUSION In this systematic review, it was concluded that the COVID-19 pandemic negatively affected the mental health of the parents of children with ASD.

ObjectivesClinical heterogeneity is a cardinal feature of systemic sclerosis (SSc). Hallmark SSc autoantibodies are central to diagnosis and associate with distinct patterns of skin-based and organ-based complications. Understanding molecular differences between patients will benefit clinical practice and research and give insight into pathogenesis of the disease. We aimed to improve understanding of the molecular differences between key diffuse cutaneous SSc subgroups as defined by their SSc-specific autoantibodiesMethodsWe have used high-dimensional transcriptional and proteomic analysis of blood and the skin in a well-characterised cohort of SSc (n=52) and healthy controls (n=16) to understand the molecular basis of clinical diversity in SSc and explore differences between the hallmark antinuclear autoantibody (ANA) reactivities.ResultsOur data define a molecular spectrum of SSc based on skin gene expression and serum protein analysis, reflecting recognised clinical subgroups. Moreover, we show that antitopoisomerase-1 antibodies and anti-RNA polymerase III antibodies specificities associate with remarkably different longitudinal change in serum protein markers of fibrosis and divergent gene expression profiles. Overlapping and distinct disease processes are defined using individual patient pathway analysis.ConclusionsOur findings provide insight into clinical diversity and imply pathogenetic differences between ANA-based subgroups. This supports stratification of SSc cases by ANA antibody subtype in clinical trials and may explain different outcomes across ANA subgroups in trials targeting specific pathogenic mechanisms.

Background: Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with severe illness have an overactive immune system, which can damage organs other than the lungs. Objective: The aim of this study was to assess the prevalence of clinical manifestations and comorbidities in SARSCoV- 2 infected patients. Patients and methods: This retrospective single-center observational study was conducted in the Tertiary Hospital, Internal Medicine Department, Faculty of Medicine, Zagazig University. This retrospective observational study was conducted on consecutive 370 patients with confirmed SARS-CoV-2 infection from May to September 2020.The diagnosis of the cases was confirmed using RT-PCR for detection of the viral RNA. Demographic characteristics, including underlying comorbidities, symptoms, signs, laboratory findings, chest CT scan and treatment measures were reported. Results: According to this retrospective, single-center observational study, which was conducted on consecutive 370 patients with confirmed SARS-CoV-2 infection? The study involved 193 Egyptian males (52.1%) and 177 Egyptian females (47.9%) with COVID-19. The mean age was 40. 2 ±14.74 years. The common symptoms of the COVID-19 patients at the onset of sickness were myalgia [355 (95.9%)], fatigue [291 (78.6%)], headache [235 (63.5%)], fever [247 (66.8%)], cough [213 (57.6.%)], sputum production [201 (54.3%)] and dyspnea [189 (51.1%)].The most prevalent comorbidity were hypertension [142(38.4%)] followed by diabetes [132 (35.6%)]. Conclusion: The commonest clinical manifestations of confirmed cases of COVID-19 were myalgia, fatigue, headache, fever, and cough and the most prevalent comorbidities associated with COVID 19 patients were hypertension and diabetes. [ABSTRACT FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Behcet’s disease (BD), commonly seen in the Silk road countries, is a variable vessel vasculitis with no specific investigation that reflects disease activity. The Behcet’s Disease Current Activity Form (BDCAF) is the most famous and acceptable clinical activity score. To develop a cross-cultural adaptation of the BDCAF to the Arabic language (Ar-BDCAF)—Egyptian dialect—across the country and to consider preliminary evaluation of its reliability in assessment of BD activity. The score was translated to Arabic language and revised by 3 rheumatology consultants. Reliability of Ar-BDCAF was tested among 88 BD patients from 9 Egyptian main city centers. Patients were questioned by two specialists at 30 min interval to evaluate inter-observer rating and twice by the same physician within 24 h to assess the intra-observer rating. Patients were 64 males and 24 females (2.7:1) with a mean age of 35 ± 10.3 years. The average time required by the consultant to fill in the form was 5.1 ± 2.2 min (1.5–15 min). The mean Ar-BDCAF scores were 9.81 ± 6.22 (0–25) and 9.53 ± 6.13 (0–28) with an intra-observer concordance (p = 0.28) and was 9.95 ± 6.47 (0–29) for the inter-observer rating (p = 0.89 and p = 0.66, respectively). The Ar-BDCAF is a measurable, easy to calculate, and reliable index for assessing disease activity in Egyptian BD. The Ar-BDCAF score can be used in daily clinical practice to assess BD activity and its use can be extended to other Arab countries for possible regional validation and adaptations.

Objective: Zinc is an essential trace element for the body that is involved in various significant body functions such as protein synthesis, DNA synthesis, and cellular growth. It is found in almost every cell and plays an important role in the immune system, affecting both innate and acquired immunity. Patients with beta-thalassemia major are at risk of zinc deficiency. Beta-thalassemia major is an inherited disease caused by a reduction or complete absence of beta-globin chains and the affected patients need repeated blood transfusions to survive. Accordingly, it causes oxidative stress and tissue damage, alteration of antioxidant enzymes, and changes in other essential trace element levels due to iron overload. Zinc levels in beta-thalassemia major patients were reported to be significantly reduced in most of the studies. Serum zinc levels of the patients with beta-thalassemia major should be monitored regularly and zinc supplementation should be provided to these patients.

Background: Cardiac catheterization is one of the most widely performed cardiac procedures. Medical record completeness and registry is a key performance indicator that is related with delivery of healthcare services in the hospital. At hospital level, statistics derived from the daily bed census and medical records are used to assess the utilization of services and enable the hospital to make appropriate financial and administrative plans and to conduct vital research.Aim of the Work: To do statistical analysis of patient’s data who underwent cardiac catheterization to evaluate the current status, the prospects of improvements and future developments.Patients and Methods: This cross sectional study included review of files of 389 patients who underwent cardiac catheterizations or invasive cardiac imaging procedures for diagnosis or treatment of various congenital heart diseases at the cardiac catheterization unit, new children's hospital, Ain Shams University during the period from first of January 2018 to the end of December 2019.Results: In our study, interventional catheterization represented 191 (49.1%) of all studied cases whereas diagnostic catheterization were 115 (29.6%). The majority of procedures were done under general anesthesia and 8 cases (2.1%) only were done under sedation. The most frequent interventional procedure done was PDA device closure (28.30%). Among our study group, the number of complicated procedures was 23 procedures representing a percentage of 5.9 % with desaturation being the most common complication (26.1%) which encountered during balloon valvuloplasty operations. Mortality was recorded in only 2 patients (0.5%). Success rate of overall procedures was 99%.Conclusion: The outcomes of the procedures done in our relatively new center were satisfactory and approximated to results of other international pediatric cardiac catheterizations centers as regards complications, mortality and success rate. Neonatal interventions were limited. Complications were higher among interventional procedures with desaturation being the most common complication which developed frequently during balloon pulmonary valvuloplasty followed by supraventricular tachycardia and arrhythmia; judicious catheter manipulation and correction of any metabolic abnormality is critical, but being prepared for such events is vital.

Objective: Detecting the level of antioxidant and tissue damage that can occur in liver tissue induced metabolic syndrome by a high fructose diet in rats and the changes after exercise and/or caloric restriction. Materials and Methods: Sprague-Dawley male rats were divided into five groups: control (C), metabolic syndrome (M), metabolic syndrome with exercise (ME), metabolic syndrome with caloric restriction (MCR), and metabolic syndrome with exercise and caloric restriction (MECR). To induce metabolic syndrome, a 10% fructose solution was given to rats in drinking water for 3 months. Exercise and caloric restriction were applied to the related groups for 6 weeks after the induction of metabolic syndrome. Glucose in the blood, lipid peroxidation (LPO), sialic acid (SA), hexosamine, mucin, fucose, glutathione (GSH) levels, alkaline phosphatase (ALP), tissue factor (TF), superoxide dismutase (SOD), catalase (CAT), and glutathione-S transferase (GST) activities were measured in rat liver homogenates. Results: In the liver, LPO levels increased and TF activities decreased in the M group compared to the C group and increased in the MCR and MECR groups compared to M group. GSH levels, SOD, and CAT activities decreased in M compared to C group and increased more significantly in MECR group compared to M group. SA levels increased in MCR and MECR groups compared with M group. Fucose levels also increased in MECR compared with the all others. Conclusion: Liver tissue damage that occurs after a fructose diet and decreased antioxidant levels was shown to improve best in combined exercise and caloric restriction treatment (MECR group).

Objectives To study the frequency of different autoantibodies to extractable nuclear antigens (ENAs) in rheumatoid arthritis (RA) patients and to correlate findings with clinical manifestations, disease activity and radiological damage. Methods A total of 230 RA patients were included and 75 healthy controls. In all patients rheumatological assessment was done and routine laboratory investigations and immune profile were performed in both patients and controls, including: RF, ACPA, ANA and anti-ENAs (Ro/SSA, La/SSB, U1-RNP, anti-Jo-1 and anti-Sm). Radiological damage was scored using Sharp/van der Heijde, and disease activity was evaluated by DAS28-ESR and DAS28-CRP. Results RF was positive in 101 (43.9%), ACPA in 220 (95.7%), ANA in 58 (25.2%), anti Ro in 31 (13.5%), anti-La in 10 (4.3%), anti-Jo1 in 5 (2.2%) and anti-RNP in 2 (0.9%). Anti-Ro/SSA positively correlated with sicca symptoms (p = .02), RF titer (p < .001), ANA (p < .001), DAS28-ESR (p = .026), and DAS28-CRP (p = .003). Anti-La antibodies correlated positively with SJC (p = .001), TJC (p = .001), ANA (p < .001), DAS-28 ESR (p = .007). Anti-Jo-1 correlated positively with interstitial lung disease (ILD) (p ≤ .001), RF titer (p = .037) and ANA (p ≤ .001). Anti-RNP antibodies correlated positively with disease duration (p ≤ .001), ACPA titer (p ≤ .001) and ANA (p = .014). In the controls ANA was positive in two (2.7%), anti-Ro in three (4%), and none of the controls tested positive for other autoantibodies. Conclusions In RA patients, positive ANA is frequent and positively associated with anti-Ro, anti-La and anti-Jo1 autoantibodies. Screening for autoantibodies against other anti-ENAs seems mandatory in RA patients especially when ANA is positive. RA cases with positive Anti-Jo-1 may develop anti synthetase syndrome and ILD.

Background/aim To determine risk factors associated with the development of insulin resistance, type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS) in gestational diabetes mellitus (GDM) patients 10 years after giving birth. Materials and methods Medical records of patients with former GDM were screened. Eligible patients were invited to the hospital to obtain information about their present health status. Patients with pregestational diabetes and patients with multiple pregnancies were excluded. A total of 67 women formed the study group. American Diabetes Association (ADA) and International Diabetes Federation (IDF) criteria were used to define T2DM and MetS, respectively. Results A total of 27 patients developed diabetes (40.3%) and 35 patients (52%) developed MetS. T2DM developed, on average, 4.8 years after delivery. There was a significant difference between diabetic and nondiabetic patients in terms of insulin use during pregnancy (P < 0.001). Women who developed diabetes within 10 years after giving birth were observed to have significantly higher fasting plasma glucose on oral glucose tolerance test during their pregnancy (P = 0.007). Current and pregestational body mass indices had a significant effect on the development of MetS (P = 0.003 and P = 0.027, respectively). Conclusion In this long-term study, we found that patients with high fasting plasma glucose (FPG) and insulin requirement during pregnancy are at an increased risk of developing T2DM, while pregestational obesity is predictive of progression to MetS. Identifying and targeting high-risk individuals may delay and possibly prevent T2DM and MetS.

Background/aim Ovarian hyperstimulation syndrome (OHSS) is a complication of ovarian stimulation with increased vascular endothelial growth factor (VEGF) and vascular permeability in the ovarian tissue. Transient receptor potential melastatin 2 (TRPM2) is known to be associated with angiogenesis and vascular permeability. In this experimental study, we aimed to investigate the activity of TRPM2 in the development of OHSS. Materials and methods Fourteen immature female rats were divided into two groups. Group 1 was the control group, and Group 2 was the OHSS group that was exposed to 10 IU of subcutaneous application of FSH for four days and 30 IU of human chorionic gonadotropin (hCG) on the 5th day. At the end of the experiment, the ovaries were removed. The right ovarian tissues were stored in 10% formol for histopathological and immunohistochemical examination. The left ovarian tissues were stored at –80 °C for biochemical examinations. VEGF, tumor necrosis factor-alpha (TNF‐α) and malondialdehyde (MDA) levels were measured in the ovarian tissue. Congestion, edema, apoptosis and TRPM2 immunoreactivity were evaluated. Results There was a significant increase in ovarian weight in the OHSS group compared to the control group. There was a significant increase in congestion, edema, apoptosis and TRPM2 immunoreactivity in the OHSS group. A significant increase in tissue levels of VEGF, TNF‐α and MDA was also found in the OHSS group compared to the control group. Conclusion As a result of our experiment, it was found that increased TRPM2 immunoreactivity on hyperstimulated rat ovary may be the reason or result of edema and congestion. Further studies are needed to discuss our results.

Background: Women with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are at high risk of cardiovascular diseases (CVD). The atherogenic index of plasma (AIP) is a new marker for the assessment of CVD. Objective: This study aimed to determine the predictive value of AIP with long-term CVD risk among women with RA and SLE. Methods: This is a cross-sectional study of 99 RA and 59 SLE women. Demographic, clinical, and biochemical data were obtained, and disease activities were calculated. For each patient, the longterm risk of CVD was calculated using the Framingham risk score (FRS); AIP was derived according to the logarithmic (triglycerides/high-density lipoproteins cholesterol). Results: The mean age of the RA and SLE patients was 47.97 ± 8.78 and 36.75 ± 9.09 years, respectively. The median (interquartile range) of AIP values in RA and SLE patients were 0.34 (-0.15, 1.02) and 0.33 (-0.53, 0.96), respectively, while FRS values of RA patients and SLE patients were 6.38 ± 5.58 and 4.86 ± 4.5, respectively (p >0.05). There was a moderate correlation between AIP and FRS in RA and SLE patients (r=0.42, p=0.002 and r=0.33, p=0.007, respectively). According to the multivariate regression analyses, we found that AIP value is an independent factor for FRS in RA (β: 4.13, 95% confidence interval; 1.71, 6.18; p=0.008) and in SLE patients (β: 6.19, 95% confidence interval; 2.58, 9.81; p Conclusions: : We reported that AIP can be used as an independent indicator for long-term CVD risk in RA and SLE patients.

Background Given the diversity of multiple sclerosis (MS) symptoms including cognitive impairment in certain domains, the need to develop a rapid and at the same time thorough tool for cognitive assessment is mandatory and represents an unmet need in the clinical and research fields of MS. The Brief International Cognitive Assessment for MS (BICAMS) is a good and practical tool to achieve this mission but is not present in the Arabic language for Arabic speaking countries yet. Objectives To assess the reliability and validity of Arabic version of the BICAMS (Egyptian dialect). Methods Ninety Egyptian MS patients and 85 matched healthy controls underwent neuropsychological testing using the BICAMS Arabic version (Egyptian dialect) battery including the Symbol Digit Modality Test (SDMT), California Verbal Learning Test 2nd edition (CVLT-II), and revised Brief Visuospatial Retention Test- (BVRT-R). Test–retest data were obtained from MS patients 2 weeks after the initial assessment. Mean differences between both groups were assessed controlling for age, gender, and educational level. Results The MS patients scored significantly lower on the SDMT, CVLT-II, and BVMT-R tests compared to healthy controls (pr values of 0.85, 0.61, and 0.68, respectively. Conclusion BICAMS Arabic version is a reliable and valid tool for cognitive assessment of Arabic speaking MS patients in different clinical and research settings.

Purpose: To firstly present management of toxic anterior segment syndrome (TASS) and possible postoperative endophthalmitis (POE) after implantation of a new hydrophilic-acrylic posterior chamber (PC) phakic intraocular lens (pIOL) in a case with undeclared history of COVID-19.Methods: A 21-year-old male without known disease represented severe anterior chamber inflammation (hypopyon), poor vision and corneal edema without vitreous involvement (TASS) at 24-hours after PC-pIOL implantation for unilateral high myopia (amblyopic).Results: Preoperative best-corrected visual acuity (BCVA) was 0.2 OS (-13 diopters). At 56-hours, vitreous was involved with visual loss indicating POE. The patient confessed that he had COVID-19 1-month ago. COVID-19 immunoglobulin M/G tests were positive, while other markers were negative. Intracameral/intravitreal antibiotics were applied. BCVA was 0.15 without hypopyon at 24-hours. Cultures were negative. Final BCVA was 0.6 with normal examination.Conclusion: TASS/POE etiology could not be demonstrated in this case, whereas COVID-19-related proinflammatory systemic background could have effect on triggering/aggravating this scenario.].

Purpose: To evaluate the levels of salusin-beta (β-SAL) in the serum in patients with age-related macular degeneration (ARMD). Methods: Our study was designed as a controlled comparative clinical study. The β-SAL levels in serums of age and sex-matched 20 healthy volunteers as controls (Group 1), 20 patients with dry-age related macular degeneration (d-ARMD) (Group 2) and 20 patients with wet-age related macular degeneration (w-ARMD) (Group 3) were measured with the enzyme-linked immunosorbent assay (ELISA) method. Results: In our study, it was found that age and gender didn’t show a statistically significant difference among the study groups (p > 0. 05). The mean serum β-SAL levels in Group 1, Group 2 and Group 3 were 1372,17 ± 1126.69 pg/mL; 1423,71 ± 1196.84 pg/mL and 940,57 ± 1092.05 pg/mL, respectively. Although the meanβ-SAL levels in w-ARMD seem numerically lower than both the control and d-ARMD groups, this difference among the study groups was not statistically significant (p > 0.05). Conclusion: Our study suggests that β-SAL levels in the patients with ARMD and healthy controls were not different than each other. Further studies with large numbers may reveal possible relationships between β-SAL and ARMD.

In this case report, we present a case of autoimmune pancreatitis (AIP) diagnosis in a patient after a 7-year history of suspicious pancreatic cancer. Kim's and Japanese criteria were used to diagnose AIP. Our case avoided undesirable invasive procedures and recovered thanks to the proper diagnosis and timely treatment with prednisone. Early and accurate diagnosis of AIP, in this case, had a significant impact on the treatment and prognosis process. (C) 2021 The Author(s) Published by S. Karger AG, Basel

Autosomal inborn errors of type I IFN immunity and autoantibodies against these cytokines underlie at least 10% of critical COVID-19 pneumonia cases. We report very rare, biochemically deleterious X-linked TLR7 variants in 16 unrelated male individuals aged 7 to 71 years (mean: 36.7 years) from a cohort of 1,202 male patients aged 0.5 to 99 years (mean: 52.9 years) with unexplained critical COVID-19 pneumonia. None of the 331 asymptomatically or mildly infected male individuals aged 1.3 to 102 years (mean: 38.7 years) tested carry such TLR7 variants (p = 3.5 × 10-5). The phenotypes of five hemizygous relatives of index cases infected with SARS-CoV-2 include asymptomatic or mild infection (n=2, 5 and 38 years), or moderate (n=1, 5 years), severe (n=1, 27 years), or critical (n=1, 29 years) pneumonia. Two boys (aged 7 and 12 years) from a cohort of 262 male patients with severe COVID-19 pneumonia (mean: 51.0 years) are hemizygous for a deleterious TLR7 variant. The cumulative allele frequency for deleterious TLR7 variants in the male general population is < 6.5x10-4 We also show that blood B cell lines and myeloid cell subsets from the patients do not respond to TLR7 stimulation, a phenotype rescued by wild-type TLR7 The patients' blood plasmacytoid dendritic cells (pDCs) produce low levels of type I IFNs in response to SARS-CoV-2. Overall, X-linked recessive TLR7 deficiency is a highly penetrant genetic etiology of critical COVID-19 pneumonia, in about 1.8% of male patients below the age of 60 years. Human TLR7 and pDCs are essential for protective type I IFN immunity against SARS-CoV-2 in the respiratory tract. Funding: The Laboratory of Human Genetics of Infectious Diseases is supported by the Howard Hughes Medical Institute, Rockefeller University; the St. Giles Foundation; the NIH (R01AI088364), the National Center for Advancing Translational Sciences (NCATS); NIH Clinical and Translational Science Award (CTSA) program (UL1TR001866); a Fast Grant from Emergent Ventures; Mercatus Center at the George Mason University; the Yale Center for Mendelian Genomics and the GSP Coordinating Center funded by the National Human Genome Research Institute (NHGRI) (UM1HG006504 and U24HG008956); the Meyer Foundation; the JPB Foundation; the French National Research Agency (ANR) under the “Investments for the Future” program (ANR-10-IAHU-01) and the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence (ANR-10-LABX-62-IBEID); the French Foundation for Medical Research (FRM) (EQU201903007798); the FRM and ANR GENCOVID project, the ANRS-COV05, ANR GENVIR (ANR-20-CE93-003), and ANR AABIFNCOV (ANR-20-CO11-0001) projects; the European Union’s Horizon 2020 Research and Innovation Program under grant agreement no. 824110 (EASI-genomics). The French COVID Cohort study group was sponsored by INSERM and supported by the REACTing consortium and by a grant from the French Ministry of Health (PHRC 20-0424). The Cov-Contact Cohort was supported by the REACTing consortium, the French Ministry of Health, and the European Commission (RECOVER WP 6). The Neurometabolic Diseases Laboratory received funding from the European Union’s Horizon 2020 Research and Innovation Program (EasiGenomics grant no. 824110 COVID-19/PID12342). A.P., R.P.d.D., C.R.-G., and C.F. were funded by Instituto de Salud Carlos III (COV20_01333 and COV20_01334), the Spanish Ministry of Science and Innovation (RTC-2017-6471-1; AEI/FEDER, UE), Fundación DISA (OA18/017), and Cabildo Insular de Tenerife (CGIEU0000219140 and “Apuestas científicas del ITER para colaborar en la lucha contra la COVID-19”). The laboratories of G.N. and A.N. were supported by a grant awarded to Regione Lazio (PROGETTI DI GRUPPI DI RICERCA 2020) no. A0375-2020-36663, GecoBiomark. A. Amara’s laboratory was supported by ANR under the “Investments for the Future” program (ANR-10-IAHU-01), the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence (ANR-10-LABX-62-IBEID), the FRM (EQU202003010193), ANR (ANR-20-COVI-000 project IDISCOVR and ANR-20-CO11-0004 project FISHBP), and the University of Paris (Plan de Soutien Covid-19: RACPL20FIR01-COVID-SOUL). This work was supported, in part, by the Division of Intramural Research, NIAID, NIH (grants 1ZIAAI001265 to H.C.S. and ZIA AI001270 to L.D.N.). The G.C. laboratory was supported by the Italian Ministry of Health (grant COVID-2020-12371617) and the intramural COVID Host Genetics program. The J.L.F. laboratory was supported, in part, by the Coopération Scientifique France-Colciencias (ECOS-Nord/COLCIENCIAS/MEN/ICETEX; 806-2018) and Colciencias contract 713-2016 (no. 111574455633). The V.S. laboratory was supported by ANR DENDRISEPSIS (ANR-17-CE15-0003) and ANR APCOD (ANR-17-CE15-0003-01), a Fast Grant from the Mercatus Center, FRM, University of Paris PLAN D’URGENCE COVID19. The N.M. laboratory was supported by Sidra Medicine (SDR400048) and the Qatar National Research Fund (grant No. NPRP9-251-3-045)

Significance The mechanisms of sighting ocular dominance, which is particularly important in monovision therapies and sports vision, are not fully understood yet. Whether the macula affects ocular dominance or ocular dominance affects the macula is also a subject of interest. Purpose The aim of this study was to investigate the relationship of sighting ocular dominance with macular photostress test time and middle macular layer thickness. Methods One-hundred eyes of 50 healthy adult volunteers were included in this cross-sectional study. Sighting eye dominance was decided by a hole-in-the-card test. The macular photostress test was performed by exposing the eye to the ophthalmoscope light for 10 seconds and measuring the time taken to return to visual acuity within one row of pre-light exposure acuity. The spectral-domain optical coherence tomography examinations were performed to measure thickness of middle macular layers (i.e., outer nuclear, outer plexiform, inner nuclear, and inner plexiform). Refractive error and intraocular pressure (IOP) measurements were also recorded. Results The comparison of dominant and nondominant eyes in the aspect of refractive error, IOP, and macular photostress test time did not show statistically significant differences (P > .05). The thicknesses of macular outer nuclear, outer plexiform, inner nuclear, and inner plexiform layers were similar in the dominant and nondominant eyes (P > .05). In addition, macular photostress time was not statistically significantly correlated with the thickness of middle macular layers (P > .05). Conclusions The thickness of middle macular layers and macular photostress recovery time are similar in dominant and nondominant eyes.

Aim The aim of this study was to evaluate nutritional status and sarcopenia in patients with inflammatory bowel disease (IBD) in clinical remission. Methods A total of 344 patients with IBD in clinical remission were included in this cross-sectional study. Patients with clinical activity (Harvey-Bradshaw index >5 for Crohn's disease and partial Mayo scores ≥5 for ulcerative colitis) were excluded. Sociodemographic, clinical, and anthropometric data were recorded. BMI was categorized according to WHO criteria. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire. Body composition included fat-free mass (FFM) analyzed with Tanita-330 ST. Muscle strength was measured with a Takei digital hand grip dynamometer using a standard protocol. Physical performance was measured as 4-m gait speed. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People 2 criteria. Results Overall, 5.5% of patients were underweight, 9.9% were malnourished, and 39.5% were at risk of malnutrition. Sarcopenia and probable sarcopenia were diagnosed in 41.3% of patients. Total number of flares requiring hospitalization (100%) was the most important predictor of sarcopenia, followed by total number of flares (80.1%), FFMI (46.5%), age (44.6%), BMI (31.8%), MNA score (27.7%), serum creatinine (23.6%), anti-tumor necrosis factor alpha use (23.3%), and gender (17.8%). Conclusion In conclusion, our findings revealed a considerable proportion of IBD patients in clinical remission to be malnourished or at risk of malnutrition along with a high rate of sarcopenia. This emphasizes the need for concomitant screening for nutritional status and body composition analysis in patients with IBD for provision of appropriate nutritional support, even during the remission period, and prevention of sarcopenia-related surgical and poor clinical outcomes.

BackgroundMultiple sclerosis (MS) is a major cause of neurological disability in adults. Depression is one of the most common psychiatric comorbidities in MS patients with negative impact on patients’ quality of life. The aim of the study is to evaluate the role of diffusion tensor imaging (DTI) in monitoring the therapeutic response after high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) versus selective serotonin reuptake inhibitor (SSRI) therapy for relapsing remitting multiple sclerosis (RRMS) patients presenting with depression by measuring the factional anisotropy of the dorsolateral prefrontal cortex (DLPFC) before and after treatment and also to assess the treatments’ impact on patients’ cognitive functions and depression.ResultsFractional anisotropy (FA) only increased in rTMS group (0.44 ± 0.03 pre-rTMS vs 0.53 ± 0.05 post-rTMS,P< 0.001), but there were no significant changes in the SSRI group (0.44 ± 0.04 pre-SSRIs vs 0.45 ± .37 post-SSRIs,P= 0.072). Both rTMS and SSRI groups showed significant clinical improvement in Beck Depression Inventory (BDI) and Paced Auditory Serial Addition Test (PASAT) after either intervention (17.6 ± 3.25 pre-rTMS vs 10.6 ± 1.89 post-rTMS and 23 ± 6.36 pre-rTMS vs 24.87 ± 6.6 post-rTMS, respectively,P< 0.001; 17.67 ± 3.15 pre-SSRIs vs 0.6 ± 1.84 post-SSRIs and 23.8 ± 6.45 pre-SSRIs vs 25.07 ± 7.02 post-SSRIs, respectively,P< 0.001).ConclusionDTI is an ideal non-invasive tool for examining white matter integrity and can detect microstructural changes in the dorsolateral prefrontal cortex after rTMS and SSRI therapies for patients with MS and depression. FA increased only with rTMS denoting positive alteration in white matter microstructure. Both rTMS and SSRIs were equally effective in improving depression and cognition.

Aim: Intravenous catheter use can cause various infections ranging from infection at the site of catheter entry to bacteremia and colonization. The purpose of this study was to identify the causative micro-organisms, and effects on morbidity-mortality of catheter-related bloodstream infections developing over the last five years. Material and Methods: Data for 194 patients who underwent central intravenous catheter insertion in our hospital’s intensive care unit and other departments between November 2014 and August 2019 were analyzed retrospectively. Blood samples taken from the catheter or the catheter tip, and blood samples collected simultaneously from the peripheral vein were included in the study, and culture results were recorded. Patients’ demographic data and the effects of the factors identified on morbidity and mortality were subjected to statistical analysis. Results: Ninety-two (47.4%) of the 194 patients included in the study were female and 102 (52.6%) were male, and mortality rate was 62.4% (n=121). The frequency of underlying medical conditions such as asthma, congestive heart failure, and cerebrovascular event, and receiving treatments such as immunosuppression, transfusion, tracheostomy, nasogastric tube, and mechanical ventilation were higher in mortal cases than non-mortal cases. A total of two hundred and forty microorganisms were detected in 194 patients, 121 (50.4%) of which were Gram negative bacteria, while 68 (28.3%) were Gram positive bacteria, and 51 (21.3%) were Candida species. Conclusion: As a result, it was observed that the advanced age, underlying diseases and presence of resistant microorganisms were higher in mortal cases.

Objectives: Patients with chronic hepatitis C virus (HCV) infectionand superinfection by hepatitis A or hepatitis B virus have highermorbidity and mortality when compared with those without HCVinfection. The aim of this study was to determine hepatitis A and Bseroprevalence rates and immunity in patients with chronic HCV indifferent regions of TurkeyMaterials and Methods: This multi-center study involving HCVinfected chronic cases was conducted between July 2016 andOctober 2017. Serological tests of Hepatitis B surface antigen, antiHBs, hepatitis B core antibody (anti-HBc) immunoglobulin G (IgG)and anti-HAV IgG were evaluated by ELISA, and the files of HCVinfected patients at the age of 18 or over who applied to 15 hospitalsin 13 different cities of our country were screened.Results: Three hundred sixty-two of the 828 patients were menand 466 were women. The prevalence of HBV/HCV coinfection was2.4%, while the anti-HBs positivity rate was 46.9%. Of the 610patients evaluated in terms of anti-HAV IgG serology, 88.8% wereanti-HAV IgG positive, while 11.1% were anti-HAV IgG negative.Isolated anti-HBc IgG positivity was detected in 5.8% of patients.Conclusion: Revealing the serological status of other hepatitisagents, such as hepatitis A and B, in patients with chronic hepatitisC is important in terms of providing the opportunity to immunize ortreat when required Gereç ve Yöntemler: HCV ile enfekte kronik olguları içeren çok merkezli bu çalışma Temmuz 2016-Ekim 2017 tarihleri arasında yapıldı. Hepatit B yüzey antijeni (HBsAg, antiHBs, antiHBcIgG ve antiHAVIgG’nin serolojik testleri ELISA ve 18 yaşında HCV ile enfekte hastaların dosyaları veya Ülkemizin 13 farklı ilinde 15 hastaneye başvuranlar tarandı. Ülkemizin 13 farklı ilindeki 15 hastanenin HCV ile enfekte hastalarının dosyaları tarandı ve ELISA yöntemi ile değerlendirilen HBsAg, anti-HBs, anti-HBc IgG ve antiHAV IgG bakıldı. Bulgular: Sekiz yüz yirmi sekiz hastanın üç yüz altmış ikisi erkek, 466 kadındı. HBV/HCV koenfeksiyon prevalansı %2,4 iken antiHBs pozitiflik oranı %46,9 idi. Anti-HAV IgG serolojisi açısından değerlendirilen 610 hastanın %88,8’i anti-HAV IgG pozitif, %11,1’i anti-HAV IgG negatif idi. Hastaların %5,8’inde izole anti-HBc IgG pozitifliği saptandı. Sonuç: Kronik hepatit C’li hastalarda hepatit A ve B gibi diğer hepatit ajanlarının serolojik durumunun ortaya konması, gerektiğinde aşılama veya tedavi fırsatı sağlama açısından önemlidir WOS:000605350300005

Objective: To evaluate the serum neutrophil gelatinase-associated lipocalin levels in pregnant women with and without preeclampsia, early-onset preeclampsia and late-onset preeclampsia, preeclampsia with and without severe features, and investigate the correlation with the neonatal outcomes.Study Design: A total of 79 pregnant women, 27 with uncomplicated pregnancies, 30 with early-onset preeclampsia, and 22 with late-onset preeclampsia were evaluated in a cross-sectional study. Neutrophil gelatinase-associated lipocalin was measured with a colorimetric Sandwich-ELISA method. Age; body mass index; systolic and diastolic blood pressure; umbilical-artery Doppler results; serum urea, bilirubin, uric acid, AST, ALT; 24-hour protein test; birth-weight; and Apgar-scores were recorded.Results: Serum neutrophil gelatinase-associated lipocalin levels were significantly higher in women with preeclampsia compared to those without preeclampsia (p