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Takayasu's arteritis (TAK) is a rare vasculitis characterized by inflammation of intermediate- to large-size arteries. Although pulmonary artery involvement (PAI) is an expected finding in some TAK patients, data on non-vascular pulmonary involvement (NVPI) are limited. We aimed to investigate the frequency of NVPI, including parenchymal infiltration, nodules/cavities, pleural effusion, and haemorrhage, in TAK. We assembled a retrospective cohort of TAK patients from nine tertiary centres in Turkey. The demographics and clinical characteristics of patients were extracted from medical records and the imaging findings were evaluated for pulmonary manifestations. As of January 2021, 319 TAK patients (female/male 276/43; mean age 42.4 ± 13.5 years) were recruited. Eighty-two patients had cough and/or dyspnoea and four had haemoptysis as pulmonary symptoms. On computed tomography assessment, the overall frequency of NVPI was 7.2%; parenchymal infiltrations were present in 10 (3.1%), pleural effusion in eight (2.5%), nodules/cavities in six (1.9%), and pulmonary haemorrhage in four patients (1.3%). In the whole cohort, 10.3% of patients had pulmonary artery hypertension (PAH) and 5.6% had PAI. Among patients with PAH or PAI, the overall frequency of NVPI was significantly higher than in the rest of the group. In this TAK cohort from Turkey, we observed NVPI in 7.2% of patients, with parenchymal infiltrations being the most common, followed by pleural effusion. Notably, NVPI was more frequent in patients with PAH or PAI. Although not as common as PAI, NVPI should be kept in mind, especially in TAK patients with PAH or PAI. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this retrospective study was to evaluate results and complications in sinus floor augmentations performed in the presence of antral pseudocyst. Materials and Methods: Two hundred thirty-five sinus floor augmentation procedures performed in 179 patients (102 men and 77 women; mean age, 46.3 years; range 24 to 77 years) were included in the study. All patients had been admitted between 2007 and 2010 and treated with sinus augmentation in a single-stage or two-stage procedure using lateral sinus floor elevation (LSFE) or in a single stage via osteotome sinus floor elevation (OSFE). Results: A total of 29 (16.2%) patients had 32 (13.6%) sinus floor augmentation procedures performed in the presence of an antral pseudocyst. Faint dome-shaped radiopacities were detected at the floor of the antrum of these patients. No sinus membrane tears occurred during elevation in the LSFE group. Two patients in the LSFE group and one patient in the OSFE group developed acute sinusitis during the postoperative period and were treated with medical therapy. No symptoms of acute sinusitis or any other complications were encountered in the remaining patients after an average 17-month follow-up period. Conclusions: Pseudocysts of the maxillary sinus may not be a contraindication for sinus augmentation by OSFE or LSFE techniques. However, detailed evaluation of patients is crucial to prevent undesirable complications. Further studies of larger patient populations are needed to reach definitive conclusions. [ABSTRACT FROM AUTHOR]

Design:A cross-sectional study.Objective:To assess the effects of pain on quality of life (QoL), functional independence and depression in patients with spinal cord injury (SCI).Setting:An inpatient rehabilitation center.Methods:A total of 140 patients (104 M, 36 F) with SCI who underwent inpatient rehabilitation treatment were examined. A questionnaire including clinical variables was applied. Motor score of Functional Independence Measure was used to assess daily-life activities, the 36-Item Medical Outcomes Short-Form Health (SF-36) for QoL and Beck Depression Inventory (BDI) for depression. Patients were then divided into those having chronic pain (Group I) and those without any pain (Group II), and groups were compared according to demographic and clinical variables.Results:The most common causes of SCI were falls (35.0%) and motor vehicle accidents (34.2%). Chronic pain was present in 78% of patients. Patients employed before injury and patients who had complete injury had lower Numerical Rating Scale scores (P<0.05). SCI patients with chronic pain had higher depression ratings and their BDI scores were correlated with some of the SF-36 domains (general health, vitality, social functioning and mental health). Only bodily pain and social functioning (P<0.05) scores were found to be lower in Group I (P<0.05) when compared with Group II.Conclusion:As mood and QoL are negatively affected with pain in SCI patients, we suggest that chronic pain should always be treated in a multidisciplinary setting where pharmacological, physical and psychological therapies are combined. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to examine the relationship between loneliness, depression and social support of Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers. Background. By altering the lifestyle of the patient and family or caregiver, chronic illness and continuous ambulatory peritoneal dialysis can create loneliness and depression. Perceived social support may facilitate coping with illness. Design. Descriptive corelational design was used. Methods. Data were collected by using the UCLA loneliness scale, the Beck's depression scale and the perceived social support from family and friends scales and demographic data form. Results. A total of 130 subjects including 65 patients with continuous ambulatory peritoneal dialysis and 65 caregivers took part in this study. The mean ages of the patients and caregivers were similar (44.69 +/- 17.22 and 43.90 +/- 8.52 years respectively). Scores of loneliness and depression were below cut-off scores in both groups. However, scores of the loneliness of patients were higher than that of the caregivers. Perceived social support from family and friend were above cut-off scores in both groups and it was different for patients and caregivers. Conclusion. The results of this study indicate that Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers did not experience loneliness and depression. Relevance to clinical practice. Results of the study suggest that the nurses need to be aware of patients' and caregivers' psychological reactions to continuous ambulatory peritoneal dialysis, which may be expressed in feelings of loneliness and depression, and employ social support resources for patients with peritoneal dialysis and caregivers to cope with their illness and to adapt lifestyle changes. [ABSTRACT FROM AUTHOR]

Pyomyositis is a rare disease, encountered mainly in tropical climates. The diagnosis of this entity is difficult, if not misdiagnosed, because of its rarity and its subacute presentation. We report of a 42-year-old man, in whom pyomyositis developed while he was receiving the standard chemotherapy for T-cell non-Hodgkin's lymphoma (NHL). Three months following splenectomy, multiple abscesses occurred in the muscles of both thighs while the patient was receiving the third course of the CHOP regimen. A purulent exudate was aspirated from the abscesses under computed tomographic guidance. Coagulase-positive Staphylococcus aureus was cultured in the aspirate. Pyomyositis was completely resolved following the surgical drainage and the antistaphylococcal antibiotic treatment. This patient has shown that immunosuppression due to splenectomy, NHL, and chemotherapy, especially when using steroids, could be risk factors for pyomyositis in nontropical or semitropical countries. [ABSTRACT FROM AUTHOR]

Background: In older age, taking medication at the desired level contributes to the health and well-being, and therefore, constitutes an essential part of the effectiveness of treatment and ultimately desired public health impact and reduced healthcare budgets. However, it is known that medication compliance among older persons is frequently not at a desired level. Therefore, in this study, it was aimed to increase medication compliance through an educational intervention for patients aged 60 and over, who applied to two healthcare facilities in Ankara, Turkey Methods: This intervention study was implemented in two public health hospitals between March and June 2019. 315 people aged 60 and over participated in the study. The intervention tool was the ‘‘teach-back’’ method. SPSS program was used for data entry and analysis. P value less than 0.05 was indicated for statistical significance. Results: Mean age of the participants was found to be 70.167.9 for the control group and 70.277.4 for the intervention group. In the intervention group, a statistically significant increase was found in the capacity of learning the long-term benefits of drugs, their side effects and storage conditions, and knowing when the drugs shouldn’t be taken, and repeating information about the drugs used (p = 0.000). Conclusions: This study has revealed that medication compliance among older individuals can be increased with an appropriate communication and training method in healthcare settings. Time allocated by health workers in this regard has a potential to respond to the compliance-related needs. With the ‘‘Teach-back’’ method utilized in the interactions between older patients and health workers, it is possible to attain meaningful, large-scale and cost-effective public health outcomes that contribute to the clinical benefits of treatments and the effectiveness of health systems. Key messages: Older people are open to receive information on the actual health needs. A well-structured interaction between healthcare workers and patients involving ‘‘teach-back’’ method contributes to medication compliance among the elderly. [ABSTRACT FROM AUTHOR]

The article presents a study by E. M. Soylu and others, which focuses on downy mildew disease caused by peronospora effusa on spinach in Turkey. Topics include in March 2017, spinach plants (cullivar Matador) showing typical symptoms of downy mildew found in four of 48 fields in the Hatay province of Turkey and initial symptoms appeared as bright chlorotic spots.

Abstract: The dimensions, mass, and shape are the most commonly measured physical properties of fruits. The size and shape features of 10 common walnut (Juglans regia L.) cultivars grown in Turkey were investigated using an image processing technique. The walnut cultivars produced nuts longer than wide and wider than thick in shape except cvs. Bursa-95, Hartley, and Şebin. The thickness of cv. Şebin was 1.07 times greater than its width. All cultivars were spherical as determined by their shape index except cv. Bursa-95 (1.32). The highest values for shape factors were obtained from the horizontal orientation, followed by the suture and vertical orientations. Mean values for mass, volume, geometric mean diameter, sphericity, and surface area ranged between 11.42 and 18.28g, 23.84 and 48.32cm3, 35.71 and 45.89mm, 83.0 and 94.1%, and 42.73 and 66.16cm2 among cultivars, respectively, and cv. Şen-1 had the highest values for all of these parameters. [Copyright &y& Elsevier]

Background: Ralstonia pickettii is an aerobic Gram-negative non-fermentative bacillus. It is an opportunistic pathogen that has recently prompted nosocomial outbreaks. Although it has low virulence, it can cause a wide range of invasive diseases in immunosuppressive patients. The characteristics of R. pickettii-related central line-associated bloodstream infection (CLABSI) outbreak in pediatric hematopoietic stem cell transplant (HSCT) recipients are presented in this study., Materials and Methods: This was a single-center, retrospective analysis conducted at Bahcesehir University Goztepe Medicalpark Hospital . The clinical and laboratory characteristics of twelve children with Ralstonia-related CLABSIs were analyzed., Results: Of the twelve patients with R. pickettii growth, seven were female. The median age was 12.1 (2-17) years. Autologous HSCT was performed in two of the patients and allogeneic HSCT was performed in ten patients for both malignant and non-malignant diseases. In the conditioning regimens, all patients were given myeloablative therapy. Clinical sepsis was the most common presentation. As a result of the investigations, R. pickettii growth was observed in saline solutions. All cases were successfully treated with the appropriate antibiotic regimen and the bacteria was not found in repeat cultures. Catheter removal was required in two patients. Mortality was not observed in any patient as the outcome of the infection episode., Conclusion: The detection and control of the infectious source are critical in pediatric HSCT patients with severe immunosuppression, as medical equipment-related outbreaks can be life-threatening., Competing Interests: The authors declare that there is no conflict of interest.

Recent studies have demonstrated that the amount of specific airborne mold types and their concentrations increase during dust events. This study investigates the seasonal variation of airborne mold concentrations before, during, and after the dust transport in an eastern Mediterranean coastal area, Izmir city, Turkey. A total of 136 airborne mold samples were collected between September 2020 and May 2021. Two different culture media, namely Potato Dextrose Agar (PDA) and Malt-Extract Agar (MEA), were used for enumeration and genus-based identification of the airborne mold. In addition to culture media, the influences of air temperature, relative humidity, and particulate matter equal to or less than 10 µm (PM 10 ) were also investigated seasonally. The HYSPLIT trajectory model and web-based simulation results were mainly used to determine dusty days. The mean total mold concentrations (TMC) on dusty days (543 Colony Forming Unit (CFU)/m 3 on PDA and 668 CFU/m 3 on MEA) were approximately 2-2.5 times higher than those on non-dusty days (288 CFU/m 3 on PDA and 254 CFU/m 3 on MEA) for both culture media. TMC levels showed seasonal variations (p < 0.001), indicating that meteorological parameters influenced mold concentrations and compositions. Some mold genera, including Cladosporium sp., Chrysosporium sp., Aspergillus sp., Bipolaris sp., Alternaria sp., and yeast, were found higher during dusty days than non-dusty days. Thus, dust event impacts levels and types of airborne molds and has implications for regions where long-range dust transport widely occurs., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Neonatal feces are one of the most important sources for probiotic isolation. The purpose of this study was the isolation and identification of Bifidobacterium spp. from neonatal feces and the evaluation of in vitro probiotic properties of strains including safety tests., Results: A total of 40 isolates were obtained from 14 healthy newborns' feces in Erzurum province, Türkiye. By their rep-PCR patterns and 16S rRNA gene sequences, isolates were identified as 26 Bifidobacterium breve and 14 Bifidobacterium longum. Fifteen of the isolates tolerated bile salts and showed high resistance to simulated gastric juice. Isolates exhibited varying rates of auto-aggregation and hydrophobicity. In addition, most of the isolates displayed antibacterial activity against Escherichia coli O157:H7, Staphylococcus aureus ATCC 29213, Salmonella Typhimurium RSHMB 95091, and Pseudomonas aeruginosa ATCC 9027. However, only one strain showed bile salt hydrolase activity and two strains showed the ability to produce H 2 O 2 . Bifidobacterium strains were generally sensitive to the tested antibiotics and lacked kanamycin, gentamicin, and streptomycin resistance genes, and hemolytic and DNAse activities. On the other hand, it was determined that five strains had various virulence genes including gelE, esp, efaAfs, hyl, and ace., Conclusion: Results of the present study suggested that B. longum BH28, B. breve BH4 and B. breve BH5 strains have the potential as probiotic candidates for further studies. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

To investigate coronavirus disease 2019 (COVID-19) in infants aged 0 to 3 months because there is currently a significant gap in the literature on the subject. A cross-sectional study was conducted with the involvement of 19 medical centers across Turkey and 570 infants. The majority of the patients were male (58.2%), and the three most common symptoms were fever (78.2%), cough (44.6%), and feeding intolerance (39.9%). The results showed that a small percentage of infants had positive blood (0.9%) or urine cultures (10.2%). Most infants presented with fever (78.2%). Children without underlying conditions (UCs) had mostly a complicated respiratory course and a normal chest radiography. Significant more positive urine culture rates were observed in infants with fever. A higher incidence of respiratory support requirements and abnormal chest findings were seen in infants with chronic conditions. These infants also had a longer hospital stay than those without chronic conditions.  Conclusions: Our study discloses the clinical observations and accompanying bacterial infections found in infants aged under 3 months with COVID-19. These findings can shed light on COVID-19 in infancy for physicians because there is limited clinical evidence available. What is Known: • COVID-19 in infants and older children has been seen more mildly than in adults. • The most common symptoms of COVID-19 in infants are fever and cough, as in older children and adults. COVID-19 should be one of the differential diagnoses in infants with fever. What is New: • Although most infants under three months had fever, the clinical course was uneventful and respiratory complications were rarely observed in healthy children. • Infants with underlying conditions had more frequent respiratory support and abnormal chest radiography and stayed longer in the hospital., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027).  Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey., Methods: The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis., Results: The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 μg/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died., Conclusion: The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management., (© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Primary antibody deficiencies (PAD) are the most common subtype of primary immunodeficiencies, characterized by increased susceptibility to infections and autoimmunity, allergy, or malignancy predisposition. PAD syndromes comprise of immune system genes highlighted the key role of B cell activation, proliferation, migration, somatic hypermutation, or isotype switching have a wide spectrum from agammaglobulinemia to selective Ig deficiency. In this study, we describe the molecular and the clinical aspects of fifty-two PAD patients. The most common symptoms of our cohort were upper and lower respiratory infections, bronchiectasis, diarrhea, and recurrent fever. Almost all patients (98%) had at least one of the symptoms like autoimmunity, lymphoproliferation, allergy, or gastrointestinal disease. A custom-made next-generation sequencing (NGS) panel, which contains 24 genes, was designed to identify well-known disease-causing variants in our cohort. We identified eight variants (15.4%) among 52 PAD patients. The variants mapped to BTK (n = 4), CD40L (n = 1), ICOS (n = 1), IGHM (n = 1), and TCF3 (n = 1) genes. Three novel variants were described in the BTK (p.G414W), ICOS (p.G60*), and IGHM (p.S19*) genes. We performed Sanger sequencing to validate pathogenic variants and check for allelic segregation in the family. Targeted NGS panel sequencing can be beneficial as a suitable diagnostic modality for diagnosing well-known monogenic PAD diseases (only 2-10% of PADs); however, screening only the coding regions of the genome may not be adequately powered to solve the pathogenesis of PAD in all cases. Deciphering the regulatory regions of the genome and better understanding the epigenetic modifications will elucidate the molecular basis of complex PADs., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: This study aimed to examine fetomaternal outcomes in pregnant women in a large Turkish Takayasu arteritis (TAK) cohort and to evaluate the effects of pregnancy on the disease in those patients., Methods: This is a cohort study involving 296 pregnancies of 112 TAK patients from 8 tertiary rheumatology centers in Turkey. Pregnancies were divided into 2 groups as pre-d (before disease onset) and post-d (after disease onset). In addition, post-d pregnancies were further divided into 2 subgroups according to fetomaternal complications (FMC) development status. Finally, patients were grouped into those with and without a history of pregnancy after disease onset., Results: In post-d pregnancies, rates of worsening hypertension, new-onset hypertension, and preeclampsia were higher than in pre-d pregnancies (0.9% vs 16%, P < .001, 0.5% vs 5.3%, P = .012, and 0% vs 4%, P = .013, respectively). Patients with FMC were more likely to have renal artery involvement (65% vs 21%, P = .003). The patients who had post-d were younger, had longer disease duration, and had more relapses number than other patients (P < .001, P = .028, P = .016, respectively). Vasculitis Damage Index (VDI) results were similar in patients with or without post-d pregnancies., Conclusion: Pregnancies after disease onset were found to be associated with HT and preeclampsia/eclampsia. HT-related FMCs are increased in TAK, and patients with renal artery involvement are at higher risk. The number of relapses increases in patients who become pregnant after disease onset, but pregnancy was not an independent risk factor for relapse. Pregnancy after the onset of disease had no negative effect on VDI., (© 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Coronavirus disease 2019 (COVID-19) is caused by the SARS-CoV-2 virus and has been affecting the world since the end of 2019. The disease led to significant mortality and morbidity in Turkey, since the first case was reported on March 11th, 2020. Studies suggest a positive association between air pollution and SARS-CoV-2 infection. The aim of the present study was to investigate the role of ambient particulate matters (PM), as potential carriers for SARS-CoV-2. Ambient PM samples in various size ranges were collected from 13 sites including urban and urban-background locations and hospital gardens in 10 cities across Turkey between 13th of May and 14th of June 2020 to investigate the possible presence of SARS-CoV-2 RNA on ambient PM. A total of 203 daily samples (TSP, n = 80; PM 2.5 , n = 33; PM 2.5 - μm, n = 19; and 6 size segregated PM, n = 48) were collected using various samplers. The N1 gene and RdRP gene expressions were analyzed for the presence of SARS-CoV-2, as suggested by the Centers for Disease Control and Prevention (CDC). According to real time (RT)-PCR and three-dimensional (3D) digital (d) PCR analysis, dual RdRP and N1 gene positivity were detected in 20 (9.8%) samples. Ambient PM-bound SARS-CoV-2 was analyzed quantitatively and the air concentrations of the virus ranged from 0.1 copies/m 10 to 23 copies/m 10 μm, n = 19; and 6 size segregated PM, n = 48) were collected using various samplers. The N1 gene and RdRP gene expressions were analyzed for the presence of SARS-CoV-2, as suggested by the Centers for Disease Control and Prevention (CDC). According to real time (RT)-PCR and three-dimensional (3D) digital (d) PCR analysis, dual RdRP and N1 gene positivity were detected in 20 (9.8%) samples. Ambient PM-bound SARS-CoV-2 was analyzed quantitatively and the air concentrations of the virus ranged from 0.1 copies/m 3 to 23 copies/m 3 . The highest percentages of virus detection on PM samples were from hospital gardens in Tekirdağ, Zonguldak, and Istanbul, especially in PM 2.5 mode. Findings of this study have suggested that SARS-CoV-2 may be transported by ambient particles, especially at sites close to the infection hot-spots. However, whether this has an impact on the spread of the virus infection remains to be determined., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background/aim: The objective of this study is to determine the clinical features of unilateral multicystic dysplastic kidney (MCDK) patients., Materials and Methods: The demographic, clinical, laboratory, and radiologic features of MCDK patients at Diyarbakır Children’s Hospital and Diyarbakır Gazi Yaşargil Training and Research Hospital between January 2008-June 2019 were retrospectively evaluated., Results: A total of 111 [59 (53.2%) male and 52(46.8%) female] patients with MCDK were followed for a mean period of 41.89 ± 32.03 months. MCDK was located on the left and right sides in 46 (41.4%) and 65 (58.6%) of the children, respectively (p > 0.05). A total of 87 (78.4%) patients had antenatal diagnosis. The mean age at diagnosis was 13.7 ± 34.2 months. Of the 49 voiding cystourethrogram (VCUG)-performed patients, vesicoureteral reflux was detected in 11 patients (22.4%). Other associated urological anomalies in the patients were detected in 12 (10.8%) patients. On Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy which was performed in all patients showed scarring in four children. Eight patients had history of UTI (7.2%). Renal failure, hypertension, and proteinuria were diagnosed in three children (2.7%). Sixty-nine (62%) patients developed compensatory hypertrophy., Conclusion: All cases should be followed up closely and VCUG should be reserved for patients with recurrent UTI and other urological problems indicated by ultrasonography and abnormal DMSA scan results., Competing Interests: none declared., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background and Aims: Lower levels of cardiovascular risk factors are associated with an increase in mortality in H.F. To explain this paradox, the term reverse metabolic syndrome (RMetS) has recently been proposed. We suggest defining these patients with lower levels of three risk factors can be combined under the heading "RMetS." We aimed to investigate the effect of MetS and RMetS on hemodynamic parameters and prognosis in patients with H.F. and reduced ejection fraction (HFrEF)., Methods and Results: We included 304 patients who were performed right heart catheterization and followed up for a median of 16 (0-48) months. We first grouped patients according to the presence of MetS or not, then we added the RMetS category and stratified patients into three groups as MetS, RMetS, and metabolic healthy. Compared with not MetS group, Pulmonary arterial pressures and VO 2 were higher in MetS group. In the second step, LVEF, CI, VO 2 I, O 2 delivery, and LVSWI were lowest in RMetS, pulmonary artery pressures were higher in MetS group. In multivariate Cox regression analysis, being in RMetS group was associated with 2.4 times and 1.8 times increased risk for composite end point (CEP) and all-cause mortality, respectively. In Kaplan Meier analysis, RMetS had the highest all-cause mortality and CEP., Conclusions: We determined that RMetS patients had the worst prognosis with unfavorable hemodynamic profile. Hence, a better understanding of the pathophysiology of RMetS may help refine the treatment targets of CV risk factors, may yield new interventions targeting catabolic syndrome., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Street dust and urban soil samples are significant part of environmental compartments to evaluate the contamination levels in urban and industrial zones. This study was carried out to ascertain the concentrations of trace and toxic elements in Izmir street dusts collected from 20 different sites dominating by industrial (four sites), residential (seven sites) and traffic (nine sites) areas, and also to figure out the exposure of adults and children to the elemental toxicity in dust. In order to measure the total and soluble concentrations of elements, the dust samples were analyzed with ICP-MS methodology. The results indicated that concentrations of anthropogenic-based elements are homogenously spread out in whole Izmir city in a similar way to crustal-based elements. This indicates that traffic and residential heating were dominant pollutant sources throughout the city dusts. The health risk assessment showed that elemental non-carcinogenic risks are lower than limit value. However, the cancer risks exceed the acceptable level for As and Cr. According to source apportionment analysis, seven factors were defined for trace elements for all site data.

The cleft lip and palate (CL/P) define a heterogeneous group of congenital deformities, which are morphologically highly diverse, with a complex and multifactorial etiology. Affected children may experience social problems due to negative effects on speech, hearing, facial appearance, as well as negative psychological effects on the parents. In 2011, after the civil war began in Syria, a great wave of immigration began to Turkey and other neighboring countries. Refugees may not be able to receive optimal health care because of cultural differences, socioeconomic status, language problems, and psychosocial problems. To increase awareness about this issue, the authors investigated the demographic, perioperative, and post-operative data of Syrian refugee patients with CL/P who were admitted to our cleft center between January 2016 and May 2019. Sixty-eight refugees with CL/P were detected as the result of the screening. Unlike the protocol the authors follow in our center, cleft lip repair was performed at an average of 7.6 months and cleft palate repair was performed at an average of 28.7 months of age. The rate of fistula was found 26.2%.The civil war in Syria has caused the repair of the patients with cleft lip and palate at a later age, hampered the follow-up and treatment, and caused more complications. Considering the demographic, social, economic and cultural characteristics of the patients, it was demonstrated that the necessary health precautions and infrastructure should be provided on the pillar of plastic surgery.

Study Design: Cross-sectional study., Objective: To investigate the role of ultrasonographic measurement of the diaphragm thickness on pulmonary function tests in patients with spinal cord injury (SCI)., Setting: Rehabilitation center in Ankara, Turkey., Methods: A total of 42 patients (34 M, 8 F) with SCI and 20 able-bodied volunteers (8 M, 12 F) were enrolled. Patients with SCI were divided into three groups according to their neurological (injury) levels. All participants underwent ultrasonographic measurements for diaphragm thickness on both sides and spirometric tests for pulmonary functions. The thickness ratio of the diaphragm was also calculated., Results: There were seven patients (5 M, 2 F) in C2-C4 injury group, 14 patients (12 M, 2 F) in C5-T5 group, 21 patients (14 M, 7 F) in T6-L2 group, and 20 able-bodied volunteers (8 M, 12 F). The diaphragms of C2-C4 group were thicker than those of the controls at end-inspirium on the right side (2.7 ± 0.7 mm vs. 2.0 ± 0.5 mm; p = 0.035). The thickness ratios of C2-C4 group were lower than those of controls on the right (0.8 ± 0.4 vs. 1.5 ± 0.5; p = 0.005) and left (0.8 ± 0.5 vs. 1.6 ± 0.7; p = 0.003) sides. For all the pulmonary function tests (except for FEV1/FVC); patients with SCI had worse results than controls; and among the SCI groups, the higher the injury level, the worse the results., Conclusion: Although patients with high-level SCI had worse pulmonary function tests and decreased the contractile capacity of the diaphragm, they had thicker diaphragm muscles than controls. This may have been due to the compensatory effect of the diaphragm (performing its maximum contraction capacity and increasing frequency of inspiration).

Background: mecA is a predefined gene causing methicillin resistance in Staphylococcus aureus (S. aureus) isolates; however, it has been shown that some methicillin-resistant S. aureus (MRSA) strains do not carry this gene. Recently, in isolates found to be MRSA-positive but mecA-negative, a new resistance gene called mecC, which is a homolog of mecA, has been reported. This study aimed to investigate the mecC and mecA genes in MRSA strains isolated from different geographic regions in Turkey., Methods: The sample of the study consisted of 494 MRSA strains isolated from seven geographical regions in Turkey between 2013 and 2016. The strains were obtained from 17 centers, comprising 13 university hospitals, three education and research hospitals, and one state hospital. Methicillin resistance in S. aureus strains was determined using the agar disk diffusion method with a cefoxitin disk and the agar dilution method with oxacillin. The mecC and mecA genes in MRSA strains was investigated by Polymerase Chain Reaction (PCR)., Results: Of the MRSA strains investigated, 47.9% were isolated from intensive care units. Concerning sample type, 36.7% were detected in the respiratory tract (tracheal aspirate, sputum, etc.), 24.8% in blood, 18.7% in skin and soft tissues, 9.3% in nasal swabs, 5.4% in urine, 4.1% in ears, and 1% in sterile body fluid. Using PCR, mecC was not identified in any of the S. aureus strains isolated from different clinical microbiology laboratories. mecA gene positivity was found in 315 of the MRSA strains (63.8%). Staphylococcal Cassette Chromosome mec (SCCmec) type was identified in 232 strains (46.9%), of which 136 (58.7%) were type II, 75 (32.4%) were type IV, 12 (5.1%) were type IIIb, six (2.5%) were type I, and three (1.3%) were type III., Conclusion: This is the first multi-centered study to investigate MRSA strains isolated from different regions in Turkey. The mecC gene was not detected in any of the MRSA strains. We believe that this study will constitute an important basis for monitoring possible future changes., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Our aim is to demonstrate any correlation between gestational diabetes mellitus (GDM) and polymorphism of the selenoprotein P (SEPP1) gene encoding the SEPP1 protein, having a role in the insulin resistance in GDM. Forty pregnant women with GDM and 40 healthy pregnant women were included in the study. In both groups, single nucleotide polymorphisms (SNPs), specifically, rs4987017, rs13154178, rs146125471, rs28919926, and rs16872762 were studied. There was no difference between the groups in terms of polymorphism rs146125471, rs28919926, or rs16872762 (p > .05). There was a significant difference in SNP rs13154178 polymorphism between the two groups (p < .01). When rs13154178 gene polymorphism was compared with AA homozygous individuals, fasting blood glucose levels were significantly higher in carriers of either polymorphism than in those with no polymorphism (p < .001). We suggest rs13154178 gene polymorphism may lead to GDM in the Turkish society.

Adropin, a secreted protein, is encoded by the energy homeostasis associated (ENHO) gene. It has been implicated in the several physiological and pathological processes such as angiogenesis and apoptosis. Therefore, the aim of present study was to investigate serum adropin levels and ENHO gene expressions in systemic sclerosis (SSc) characterized by vasculopathy, inflammation, and progressive fibrosis of the skin and internal organs. The study includes 27 patients with SSc, 39 patients with Behçet's disease (BD), and 20 healthy controls (HC). Serum adropin levels and ENHO gene expressions by peripheral blood mononuclear cells were analyzed by ELISA method and by real-time PCR, respectively. The serum adropin levels were higher in the SSc and BD groups than in the HC group (p = 0.023 and p < 0.001, respectively). However, there were no significant differences among the groups in terms of ENHO gene expressions (p ANOVA = 0.149). There was no significant difference between the limited and diffuse cutaneous subtypes of SSc in terms of serum adropin level and ENHO gene expression. Moreover, serum adropin level and ENHO gene expression were not associated with the disease activity and severity indexes. ENHO gene expression was correlated with the triglyceride levels in the BD group (r = -0.426, p = 0.027). The augmented serum adropin levels may be expected in the chronic inflammatory disease and seem not to be characteristic of only SSc. However, further studies are needed to explain the precise role of adropin in SSc.

Several trace and macro elements (n=48) were measured in pine needle, branch, bark, tree ring, litter, and soil samples collected at 27 sites (21 industrial, 6 background) to investigate their spatial and historical variation in Aliaga industrial region in Turkey. Concentrations generally decreased with distance from the sources and the lowest ones were measured at background sites far from major sources. Spatial distribution of anthropogenic trace elements indicated that their major sources in the region are the iron-steel plants, ship-breaking activities and the petroleum refinery. Patterns of 40 elements that were detected in most of the samples were also evaluated to assess their suitability for investigation of historical variations. Observed increasing trends of several trace and macro elements (As, Cr, Fe, Mo, Ni, V, Cu, Pb, Sb, Sn, and Hg) in the tree-ring samples were representative for the variations in anthropogenic emissions and resulting atmospheric concentrations in Aliaga region. It was shown that lanthanides (La, Ce, Pr, Nd, Sm, Gd, Dy, Er, Yb) could also be used for the investigation of historical variations due to specific industrial emissions (i.e., petroleum refining). Results of the present study showed that tree components, litter, and soil could be used to determine the spatial variations of atmospheric pollution in a region while tree rings could be used to assess the historical variations., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Normalized biogenic volatile organic compound (BVOC) emission rates for thirty one tree species that cover the 98% of national forested areas in Turkey were determined. Field samplings were performed at fourteen different forested areas in Turkey using a specific dynamic enclosure system. The selected branches of tree species were enclosed in a chamber consisted of a transparent Nalofan bag. The air-flows were sampled from both inlet and outlet of the chamber by Tenax-filled sorbent tubes during photosynthesis of trees under the presence of sunlight. Several environmental parameters (temperature, humidity, photosynthetically active radiation-PAR, and CO2) were continuously monitored inside and outside the enclosure chamber during the samplings. Collected samples were analyzed using a gas chromatography mass spectrometry (GC/MS) system equipped with a thermal desorber (TD). Sixty five BVOCs classified in five major groups (isoprene, monoterpenes, sesquiterpenes, oxygenated sesquiterpenes, and other oxygenated compounds) were analyzed. Emission rates were determined by normalization to standard conditions (1000 μmol/m(2)s PAR and 30 °C temperature for isoprene and 30 °C temperature for the remaining compounds). In agreement with the literature, isoprene was mostly emitted by broad-leaved trees while coniferous species mainly emitted monoterpenes. Several tree species such as Sweet Chestnut, Silver Lime, and European Alder had higher monoterpene emissions although they are broad-leaved species. High isoprene emissions were also observed for a few coniferous species such as Nordmann Fir and Oriental Spruce. The highest normalized total BVOC emission rate of 27.1 μg/gh was observed for Oriental Plane while South European Flowering Ash was the weakest BVOC emitter with a total normalized emission rate of 0.031 μg/gh. Monoterpene emissions of broad-leaved species mainly consisted of sabinene, limonene and trans-beta-ocimene, while alpha-pinene, beta-pinene and beta-myrcene were generally emitted by coniferous species. Oxygenated compounds were the third most prominent BVOC group and sesquiterpenes had slightly lower contributions., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Integrin αvβ3 (vitronectin receptor) plays a prominent role in angiogenesis, a key pathogenic feature of rheumatoid arthritis (RA). Moreover, integrin αV (ITGAV) subunit gene has been associated with a susceptibility to RA. The aim of the present study was to detect the potential association between ITGAV gene polymorphisms and a susceptibility to RA in a Turkish cohort. DNA samples were harvested from 160 patients with RA and 144 healthy controls (HC). Three single-nucleotide polymorphisms of ITGAV gene (rs3738919, rs3768777, and rs10174098) were genotyped using real-time PCR. Serum vitronectin levels were analyzed in 30 RA patients, 28 Behçet's disease (BD) patients, and 30 HC subjects. There was no significant difference between the RA and HC groups in terms of the genotypic and allelic distributions of rs3738919 and rs10174098 polymorphisms. However, the prevalence of rs3768777-G allele was higher in the RA group than in the HC group (OR 2.3, 95 % CI 1.6-3.2, p < 0.0001). Moreover, there was a significant association between RA and the genotypic distribution of rs3768777 (GG + AG vs. AA: OR 2.1, 95 % CI 1.3-3.4; GG vs. AG + AA: OR 4.1, 95 % CI 2.1-7.8). Serum vitronectin levels were lower in the RA and BD groups than in the HC group (p ANOVA = 0.002). The rs3738919 and rs10174098 polymorphisms of the ITGAV gene seem not to be associated with susceptibility to RA in Turkish patients. However, rs3768777 increases the risk of RA in this group. These results suggest that the ITGAV gene may be a candidate gene for the etiopathogenesis of RA.

Background: A number of procedures have been used in the management of malignant pleural effusion including repeated thoracentesis, tube thoracostomy, drainage with catheter, chemical pleurodesis, pleurectomy and pleuro-peritoneal shunt. However, the optimal method of management remains unclear. On the other hand, single incision thoracoscopic surgery has been defined as a less invasive method than the standard threeportal videothoracoscopy. We herein present our series of patients who underwent single incision thoracoscopic pleurectomy for malignant pleural effusion., Patients and Methods: We performed a single incision thoracoscopic pleurectomy in a total of 19 consecutive patients, 11 (57.8%) male and 8 (42.2%) female with a mean age of 56.3 +/- 16.9 years who had malignant pleural effusions. We made a single 2-2.5 cm incision at the seventh or eighth intercostal spaces on the midaxillary line for the procedure., Results: We performed a total of 23 single incision thoracoscopic total pleurectomies consisting of 11 (57.8%) right-sided, 4 (21.1%) left-sided and 4 (21.1%) bilateral procedures. The mean total postoperative drainage was 553 +/- 266 cc (Median; 470 cc), and the mean chest tube removal time was 2.3 +/- 0.4 days (Median; 2 days). We observed neither morbidity nor mortality. No patient required an additional port or a conversion to thoracotomy. Median follow-up was 83 days (range, 30 to 359 days). Pleural effusion recurred in two (8.6%) out of 23 procedures which resulted in a success rate as 91.4% for the procedure., Conclusion: Single incision thoracoscopic pleurectomy is a safe, less invasive and an effective method of pleurodesis with a low recurrence rate in patients with malignant pleural effusion.

Colorectal cancer is an important cause of death throughout the world, and its etiology involves the interaction of genetic and environmental factors. Transporter proteins are important in protecting organs from xenobiotics or toxins. Organic anion-transporting polypeptide 1B1 (OATP1B1) plays role in hepatic uptake and clearance of albumin-bound amphipathic organic compounds, including endogen substances, drugs, or xenobiotics. The SLCO1B1 gene expressing OATP1B1 is highly polymorphic. Up to now, SLCO1BI variants were the focus of several investigations on drug pharmacokinetics and cancer susceptibility. However, no information has been available on association between SLCO1B1 and colorectal cancer risk. Therefore, the study aims to investigate the relationship between colorectal cancer and the functional common variants of SLCO1B1 (388 A>G, -11187 G>A, 521 T>C) and to estimate the prevalence of these variants in the Turkish population. To that end, the distributions of the variants were determined in 100 patients with colorectal cancer and 150 healthy volunteers. SLCO1B1 521 T>C was statistically significantly associated with colorectal cancer risk (odds ratio [OR]=2.66; 95% confidence interval [CI]=1.31-5.41; p=0.0057). In haplotype-based analysis, SLCO1B1 haplotype G(388)-T(11187)-T(521) might be associated with the development of colorectal cancer (OR=4.26; 95% CI=1.62-11.16; p=0.002). We believe that the findings may be beneficial to the development of efficacious preventive strategies and therapies for colorectal cancer.

Objective: To evaluate the possible risk factors of heterotopic ossification (HO) in traumatic brain injury (TBI) patients., Methods: A total of 151 patients with TBI were included. Demographical variables, laboratory investigations and risk factors for HO including spasticity, walking ability (using Functional Ambulation Category (FAC)), pressure ulcer, neurogenic bladder and systemic infection were recorded., Results: Fifty-six patients (37.1%) had HO. Time since injury and serum ALP and ESR levels were significantly higher in HO patients than in non-HO patients. Hip (73.2%) and knee (44.6%) were the most commonly involved joints. This study has detected significant associations between FAC scores (FAC 0-1-2 vs. FAC 3-4-5, p < 0.001), degree of spasticity (p = 0.01), pressure ulcer (Absent/Grade 1 vs. Grade 2, 3 and 4, p = 0.001), presence of neurogenic bladder (p < 0.001) and systemic infection (p = 0.002) with the development of HO. According to the final logistical regression analysis, only lower FAC score was independently associated with HO development (p = 0.006)., Conclusion: As lower scores of FAC is an independent risk factor for HO formation and is related to the severity and consequences of injury, ambulation and regular/cautious mobilization of the joints are of paramount importance in the early period of the rehabilitation in TBI patients.

Aim: Patients displaying flow cytometric crossmatch results within the grey zone of positivity are hard to evaluate, especially if they are undergoing their first transplantation. For these patients assays of donor-specific anti-HLA (human leukocyte antigen) antibodies with complement-fixing properties to cause cell lysis are important for antibody-mediated rejection and graft failure. The aim of this study was to detect the relevance of serum C1q-binding antibodies detected in renal recipients with grey zone crossmatch reactivity who were considered to show low levels of sensitization against their potential donors., Method: This study includes 114 patients who were admitted for their first renal transplantation between September 2009 and August 2011, including 33 subjects considered by flow cytometric cross-match to be the sensitized group, whereas the remaining 81 recipients had negative results. We analyzed the accumulation of serum the immunoglobulin (Ig)G bound C1q on HLA-coated flow cytometric panel reactive antibody (FlowPRA) beads. The serum samples were retrospectively analyzed with [C1q]FlowPRA (HLA class I and II), which were collected during the pretransplantation period every 6 months and every week posttransplantation within the first month and every 3 months thereafter. All serum samples were analyzed for the presence of anti-FlowPRA IgG alloantibody. We compared the C1q FlowPRA-positive and-negative groups for the number of posttransplantation days that the serum creatinine level was below <2 mg/dL as a metric of graft function., Results: With a mean follow-up of 492 ± 84 days, there was a significant difference between flow cytometric crossmatch results and creatinine decrease rate (P = .02). The serum creatinine decrease rates of the 9 C1q-positive versus the 15 C1q-negative subjects showed significant difference (P < .05)., Conclusion: C1q-binding antibody analysis shows the presence of serum antibodies capable of complement binding and antibody-mediated rejection, which could be useful to assess rejection risk among the "grey zone" of renal recipients with low levels of sensitization against their donors., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: Acute and chronic humoral injuries in renal transplant recipients are the main reasons for graft rejection and failure. Histological and clinical characteristics of humoral rejection and symptoms are variable and not always helpful for differential diagnosis. Clinical monitoring of the allograft, an elevated serum panel-reactive antibody (PRA), and the presence of donor-specific antibody (DSA) during immune monitoring as well as C4d staining of biopsy material can establish the differential diagnosis. Even without a cellular component, humoral rejection reaction is serious because the target tissue is the graft endothelium. Because the kidney graft has a rich vascular structure this attack causes permanent injury to the kidney in the long term. Graft dysfunction in this setting is usually more severe, requiring dialysis therapy, compared with acute cellular reactions. Positive C4d staining of peritubular capillaries in biopsy material represent a hallmark of complement-dependent cytotoxicity, supporting the diagnosis of humoral rejection. We analyzed C4d staining as a hallmark of humoral rejection., Methods: From 2009 to 2011, we analyzed the relationship between pathological findings of C4d immunohistochemistry staining and the clinical outcomes of 45 kidney transplant recipients who underwent a kidney biopsy because of graft dysfunction due to possible humoral rejection., Results: Biopsy specimens of 15 patients stained C4d positive; the remaining 30 showed negative results. Intravenous steroids, PP + IVIG with or without antithymocyte globulin (ATG), was administered for treatment. Sixty six percent (n = 10) of patients were C4d positive with 16% (n = 5) of those showing C4d-negative biopsy results, losing their grafts, and returning to hemodialysis., Conclusions: C4d staining refractory humoral rejection injury was related to poor graft outcomes., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Familial Mediterranean fever (FMF) is an auto-inflammatory disorder characterized by febrile attacks. Increased acute-phase reactants are characteristic during febrile attacks. Ghrelin is a natural G-protein that decreases secretion of pro-inflammatory cytokines and acts as anti-inflammatory agent. The aim of this study was to investigate whether there is any change in ghrelin levels and whether increases in ghrelin levels can be used as a marker in these patients., Subjects and Methods: Thirty-seven male patients and 30 healthy men as a control group were included in the study. Blood samples were obtained for ghrelin measurements both before the attacks (pre-attack period; ghrelin 1 group) and during the attacks (ghrelin 2 group). Samples were kept at -80°C until the analysis was conducted and plasma ghrelin levels were measured using an immune-sorbent assay method., Results: Mean ghrelin levels measured during the attacks were significantly higher (11.01 ± 4.78 pg/ml) as compared to pre-attack levels (5.78 ± 2.17 pg/ml; p < 0.001). Similarly, mean ghrelin levels measured in FMF patients during an attack were significantly different from that of the control group (6.57 ± 4.13 pg/ml; p < 0.001)., Conclusions: In this study, high ghrelin levels were measured during attacks in FMF patients. This finding is in line with previous results regarding the fact that inflammatory response arising during an FMF attack is an acute inflammatory event. Our findings suggest that ghrelin levels measured during FMF attacks could be used as a biochemical indicator for the FMF attack in FMF patients and that it could be used for support of the diagnosis of the disease.

Purpose of Investigation: The aim of this study was to detect the incidence, indications, maternal and perinatal outcomes, and complications of emergency peripartum hysterectomy (EPH) as a life-saving operation., Methods: Fifty-four cases of emergency peripartum hysterectomy between June 2003 and June 2009 at the Obstetrics and Gynecology Department of the Agri Maternity and Children's Hospital in Turkey, were analyzed retrospectively., Results: The incidence of EPH was found to be 1.87 per 1,000 deliveries. The most common indication for the procedure was uterine rupture (37.03%). There were three maternal deaths (5.56%). Wound dehiscence and wound infection were seen in eight (14.81%) and nine patients (16.67%), respectively., Discussion: EPH continues to be an important factor for maternal morbidity and mortality. In our study, we aimed to investigate the risk factors for peripartum hysterectomy. The most common three risk factors were uterine rupture, atony, and placenta accreata.

Purpose of Investigation: To detect the prevalence, types and risk factors of urinary incontinence (UI) in postmenopausal women., Methods: Three-hundred and thirty-three patients who were referred to our Menopause Clinic between August 2008 and May 2009 were included in the study according to the acceptance criteria. A detailed questionnaire was completed by the patients who were between 31-65 years of age., Results: The mean age was 52.5 and the mean age at which menopause symptoms started was 45.8. The prevalence of urinary incontinence was found to be 45.6%. The most frequently seen UI type was mixed urinary incontinence (68.4%). Advanced age, vaginal delivery, high BMI and no hormone replacement therapy were regarded as significant risk factors., Conclusion: UI is a common problem influencing the social experience of postmenopausal women. The prevalence of UI was detected as 45.6% in our study. The quality of life in postmenopausal women can be augmentated by diagnosing the risk factors of UI and making an effort to improve the condition.

Introduction: We attempted to establish the frequency of uterine rupture and to address etiological factors, complications, management and maternal and perinatal outcome of complete versus incomplete rupture, with the aim of proposing preventive measures., Methods: The clinical records of uterine rupture cases managed at the Obstetrics and Gynecology Department of Agri Maternity and Children's Hospital in Turkey from June 2004 to June 2009 were analyzed retrospectively., Results: There were 44 cases of ruptured uterus. Among 24,554 deliveries the total incidence of uterine rupture was 1/558 or 17%. The most common site for the location of rupture was the fundal region (36.36%) followed by the lower segment, isthmic and mixewd types, respectively., Discussion: Prevention must necessarily include regular antenatal care and meticulous screening of high-risk patients. Improved organization and access to maternal care, decentralization of obstetric services into peripheral care units in villages to prevent home deliveries and good supervision during labor can reduce the incidence of this preventable obstetric catastrophe.

Municipal solid waste (MSW) is one of the most important environmental problems arising from rapid urbanization and industrialization. The use of alternative fuels in rotary kilns of cement plants is very important for reducing cost, saving fossil fuels and also eliminating waste materials, accumulated during production or after using these materials. Cement industries has an important potential for supplying preferable solutions to the waste management. Energy recovery from waste is also important for the reduction of CO(2) emissions. This paper presents an investigation of the development of refuse derived fuel (RDF) materials from non-recycling wastes and the determination of its potential use as an alternative fuel in cement production in Istanbul, Turkey. RDF produced from MSW was analyzed and its effects on cement production process were examined. For this purpose, the produced RDF was mixed with the main fuel (LPG) in ratios of 0%, 5%, 10%, 15% and 20%. Then chemical and mineralogical analyses of the produced clinker were carried out. It is believed that successful results of this study will be a good example for municipalities and cement industries in order to achieve both economic and environmental benefits.

This study was carried out to determine the prevalence of Cryptosporidium species in diarrhoeic lambs and investigate some risk factors in Kars province (Northeastern region of Anatolia) in Turkey. Four hundred faecal samples were taken from the rectums of clinically diarrhoeic and aged to 1-month-old lambs from 34 sheep farms in 20 villages in March-April 2007 and examined by using the modified acid-fast staining technique. The prevalence of Cryptosporidium species was found as 38.8% (155/400). Cryptosporidium oocysts were detected in 90.0% (18/20) of villages and in 76.5% (26/34) of the sheep farms. Infection rates were detected as: 44.4% (67/151) in 1-week-old lambs, 37.5% (39/104) in 2-week-old lambs, 40.0% (38/95) in 3-week-old lambs, and 22.0% (11/50) in 4-week-old lambs. Farms classified according to their zoohygienic conditions and fine, average and bad conditioned farms were contaminated with Cryptosporidium with the percentages of 14.7%, 20.6% and 41.2%, respectively. Clinical cryptosporidiosis was determined in 35.0% of the villages (7/20) and in 29.4% of the sheep farms (10/34), Cryptosporidium oocysts were found in 81.3% of the lambs (91/112) in these farms. Cryptosporidiosis may be a major epidemiological significance in lambs in Kars province, and suggests that naturally infected lambs may be reservoirs of Cryptosporidiosis infections for calves even for humans too.

This study was carried out to determine the prevalence of cavical myiasis caused by Oestrus ovis larvae in sheep of Kars province of north-eastern part of Turkey. From 30 to 35 sheep heads (total of 387) were examined every month regularly for O. ovis larvae during 12 months. Of 387 heads, 156 (%40.3) were infested with O. ovis larvae.. The prevalence of nasal myiasis was 54.3% in spring, 41% in summer, 28% in fall, and 38.9% in winter. The differences among seasons were significant statistically (P<0.05). Infestation rate up to 1-years-old was 30.0%, 1 to 3 years-old 40.0% and older than 3 years old was 52.4%. The number of larvae made peak in spring months and went down in the months of fall. The mean number of larvae regarding examined animals was 1.8, and the mean according to infested animals was 4.5. Density of O.ovis larvae in infested sheep were changed from 1 to 31. Infestation rate in the morkaraman breed was higher (43.4%) comparing to the rate in the akkaraman breed (31.3%). The differences between sheep breed were also significant (p<0.05). Sheep with dark colored head had higher infestation rate than that of sheep with light colored head (p<0.05).

Aims: It has been hypothesized that the activation of the immune system may be involved in the neuropathological changes occurring in the central nervous system of schizophrenic patients. Cytokines play a key role in the activation of the immune system. Moreover, they strongly influence the dopaminergic, noradrenergic and serotonergic neurotransmission. To the best of our knowledge, in schizophrenic patients, plasma levels of interleukin (IL)-12 were investigated only in one study, where deregulation of IL-12 was determined. However, genotypical variations of the IL-12B (p40) gene have not been investigated for schizophrenic patients yet. Therefore, in the present study, we aimed to examine polymorphic variants of IL-12B (p40) gene promoter region in patients with schizophrenia in a population of the Elazig Region of East Anatolia, Turkey., Methods: One hundred Turkish patients diagnosed with schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and 116 healthy control subjects participated in the present study. The genotype characteristics were determined by polymerase chain reaction-based restriction fragment length polymorphism method using DNA extracted from peripheral blood., Results: Significant differences in both the genotype and allele frequencies were found between schizophrenia patients and control groups (P < 0.01)., Conclusions: These findings may support the hypothesis that activation of the inflammatory response system and in particular, of Th-1 cells, is involved in the pathophysiology of schizophrenia. We think that this study is the first trial associated with IL-12 cytokine at the molecular genetic level on immune mechanisms for neuropsychiatric disorders including schizophrenia, and this perspective and the role of the cytokines in the pathogenesis of schizophrenia may constitute a reasonable target for the present and future treatment strategies and prognosis.

Aim: To determine whether the Roper, Logan and Tierney Model of nursing care affects the outcomes of patients with chronic obstructive pulmonary disease., Background: Chronic obstructive pulmonary disease is a leading chronic health problem throughout the world. Although there are numerous studies on patients with chronic obstructive pulmonary disease, no studies have been found regarding patient care with chronic obstructive pulmonary disease investigated from the Roper, Logan and Tierney Model perspective., Methods: The study design was an experimental style. The sample consisted of 60 subjects with a diagnosis of chronic obstructive pulmonary disease who were hospitalized in a university hospital in Erzurum, Turkey, in 2001 and randomly selected into control and experimental groups. On admission, the researcher completed a nursing diagnosis form for chronic obstructive pulmonary disease for each patient, consisting of demographic characteristics and an assessment nursing diagnosis for each of the patients. Control group patients were treated by routine nursing care while the experimental group patients were treated by nursing care according to the Roper, Logan and Tierney Model. Upon discharge, nursing diagnoses were assessed again in both control and experimental groups. Results. Although there was no statistically significant decrease in most nursing diagnoses in the control group, there was a statistically significant decrease in nursing diagnoses in favour of the experimental group., Conclusion: This study demonstrated that there were improvements in patient's outcomes in the concept of holistic and individualized nursing care of patients with chronic obstructive pulmonary disease according to the Roper, Logan and Tierney model., Relevance to Clinical Practice: The findings of this study have practical importance for nursing practise. Using the Roper, Logan and Tierney Model in care of patients with chronic obstructive pulmonary disease may serve as a guide for nurses working with chronic obstructive pulmonary disease patients to participate patient and her/his family to patient care and to facilitate the effectiveness of patient care.

Background: As a profession, nurses are particularly concerned with cross-cultural influences that affect the health practices of populations. Although the international literature describes questionnaires and specific scales in health and disease behaviours, adequate Turkish-language instruments are scarce. Therefore, suitable Turkish-language instruments need to be developed or adapted for the Turkish population., Objectives: Study aim was to adapt a Dutch/English version of the diabetes management self-efficacy (SE) scale for use with a Turkish population and evaluate its psychometric properties., Design: Methodological research design., Settings: Attendants of an outpatient clinic of a university hospital in Turkey., Participants: A convenience sample of 110 patients with type 2 diabetes mellitus (DM)., Methods: Translation and back-translation of the original English instrument and content validation through a expert panel were the first two steps of the study. Third step was the psychometric testing of the adapted instrument by establishing internal consistency (Cronbach's alpha), stability (test-retest reliability), and construct validity (factor analysis)., Results: Content validity procedure resulted in a final scale that consisted of 20 items. Internal consistency of the total scale was coefficient alpha=0.88, and test-retest reliability with a 4-week time interval was r=0.91 (p<0.001). Factor analysis yielded three factors related to diet, exercise and medical treatment. Two relevant items of the scale, weight control and blood sugar control, however, had low reliability and validity scores., Conclusions: Although acceptable levels of reliability and validity of the Turkish version of the diabetes management SE scale for people with type 2 DM were reached, cultural factors appeared to play a role in the applicability of some items of the scale.

A total of 1276 cattle from 76 farms in 8 villages were examined by palpation of the skin for evidence of hypodermosis. The effects of age, sex, breed, and colour of cattle on hypodermosis were investigated. The overall prevalence was 31.9%. The mean number of warble fly larvae on infested animals was 8.46. Hypodermosis infestations were encountered in all the villages visited. Within a herd, the intensity of infestion decreased with the age of cattle. Infestation rates of warble fly larvae were lower in native cattle, in females, and in piebald animals.

This study was designed to compare the effect of structured education on self-efficacy in patients with chronic obstructive pulmonary disease (COPD). The study was carried out with an experimental group on which a structured education was provided, and a control group on which only educational advice was provided. There were 30 patients in both groups. Control and experimental group measurements were obtained on the COPD Self-Efficacy Scale (CSES). There was a significant difference between control group and experimental group scores on the CSES. Self-efficacy, as it affects managing or avoiding breathing difficulty, was measured before and after the structured education program and the nursing care. Patients' self-efficacy scores significantly improved after the structured education and remained significantly improved 1-month later. Standard nursing care alone was also effective in significantly improving self-efficacy scores, but patients' scores 1-month later were not significantly better than pre-program scores. This study indicates that a planned education program that is more effective in improving self-efficacy in patients with COPD.

Purpose: To identify the differences in loneliness, depression, and social support among Turkish patients with COPD and their spouses., Design: The convenience sample consisted of 30 patients with COPD and their spouses. Descriptive statistics, Student's t tests, and Pearson product moment correlations were used to analyse the data., Methods: Data were collected during structured interviews in an outpatient clinic in Turkey by using the UCLA Loneliness Scale, the Beck Depression Inventory and Perceived Social Support from Friends and Family scales., Findings: Levels of loneliness, depression, and perceived social support from family and friends were similar for patients and spouses. Loneliness and depression were positively related, but both loneliness and depression were greater with less perceived social support from family and friends for both patients and their spouses., Conclusions: Patients' and spouses' psychologic reactions to COPD might include feelings of loneliness and depression, which might be alleviated by social support.

Hamdi Suad Aknar [1873-1936] was one of the pioneers of pathological anatomy and cancer researches in Türkiye. He completed his education in the military medical school in 1899. Then he started to work at Gülhane, which was a school for training military physicians as interns and residents. He was sent to Germany by Robert Rieder, head of Gülhane, for further education. He got his specialization certificate at the University of Leipzig. When he returned to Gülhane he was appointed as an instructor and started courses of pathological anatomy. He taught pathology at the Mekteb-i Tibbiye-i Mülkiye and the Darulfünun Medical School, too. In 1933, as a result of the university reform, he was dismissed. When he died, he was the head of the pathological anatomy laboratory of the Gureba Hospital in Istanbul. When he returned from Germany, Aknar modernized the laboratory of the pathological anatomy department of Gülhane, which was the first in its field in Türkiye. He founded a pathology museum, which consisted of 1800 macroscopic pieces, in the medical school and prepared a collection of microscopic pieces, as well. He concentrated on cancer research and studied in the field of cell and tissue pathology. He founded a cancer research department in his laboratory in the university. The Society for Research and Strugle Against Cancer (Kanser Mücadele ve Taharri Cemiyeti) was established in 1932, on Hamdi Suad's proposal. He wrote two textbooks for students: General Pathological Anatomy (Teşrih-i Marazi-i Umumi) and Autopsy and Pathological Anatomy Diagnosis and Its Importance in Forensic Medicine (Feth-i Meyyit ve Teşrih-i Marazi Teşhisi ve Tibb-i Adlide Ehemmiyeti.) He was granted a prize of service by the Turkish Scientific and Technical Research Foundation (Türkiye Bilimsel ve Teknik Araştirma Kurumu) in 1974, 38 years after his death.

Coccidia were detected in the faeces of 556 out of 592 sheep (93.9%) in sheep in Kars province. The prevalence of coccidiosis was significantly higher (p < 0.01) in young (97.9%) and immature sheep (96.6%) than in adult sheep (90.2%). Mixed infections were widespread (71.5%). Ten species of Eimeria were recognized. These species (and their prevalences) were: Eimeria ovinoidalis (47.7%), E. bakuensis (E. ovina) (46.6%), E. parva (37.1%), E. granulosa (27.7%), E. ahsata (23.4%), E. pallida (23.2%), E. faurei (15.1%), E. intricata (13.9%), E. crandallis (13.7%) and E. punctata (2.3%). Eimeria punctata is reported in sheep from Turkey for the first time. The mean oocyst count from infected animals was 3451 +/- 409 opg (range 50-117,600). The mean was higher (9529 +/- 502) in young sheep. Differences in the counts from young, immature and adult sheep were statistically significant (p < 0.01). However, no clinical cases of coccidiosis were encountered.