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Purpose: Multiple Sclerosis (MS) is a disease of the central nervous system characterized by multiple areas of inflammation and demyelination in the white matter of the brain and spinal cord. MEFV gene, which is the main factor in familial Mediterranean fever, is an intracellular regulator of inflammation. This study was designed to determine if known mutations in pyrin domain of MEFV gene are involved in MS and associated with MS morbidity. Methods: Fifty-three patients with MS and 66 healthy subjects, who were all Turkish, were included in this study. Five pyrin gene mutations (E148Q, M680I, M694V, M694I and V726A) were detected in the patients and controls by using the PRONTO™ FMF Basic Kit according to the manufacturer's instructions. Results: Pyrin gene mutations were found in 20 of the 53 MS patients (38%) and in seven of the 66 healthy subjects (11%). The frequency of total pyrin domain mutations was significantly higher in the MS patients than in the healthy subjects (p < 0.0001). The frequencies of M694V, E148Q and V726A mutations were significantly higher in the patients than in the healthy subjects (p = 0.02, p = 0.013, p = 0.004 respectively). The mean time to reach EDSS score 3.0 was earlier in the patients with MEFV gene mutation (p = 0.02) and the relapse rate was slightly higher among the MS patients carrying MEFV gene mutation (p = 0.04). Conclusion: The results of this study supported the hypothesis that MS patients with MEFV mutation seem to have the susceptibility to develop a more progressive disease. Moreover, these data suggest that MEFV mutations may increase the risk of MS development. © 2010 Elsevier B.V. All rights reserved.

Background and purpose: Apolipoprotein E (apoE) polymorphism is suggested to be a risk factor in stroke in some populations, either by affecting lipid parameters or independently. Its effect on lipoprotein(a) [Lp(a)] is not known. The roles of apoE polymorphism and of high Lp(a) levels in atherosclerotic stroke (AS) in the Turkish population are unclear. Our aim was to investigate the relationship of apoE alleles and Lp(a) level with AS and the relationship of apoE alleles with Lp(a) and other lipid parameters. Methods: ApoE polymorphisms and lipid parameters were prospectively evaluated in 85 patients and 77 controls with normal brain imaging. Results: Only hypertension, diabetes mellitus, associated vascular diseases and decreased high-density lipoprotein cholesterol levels were found to be independent risk factors for stroke. However, in the presence of apoE/E4 allele, increased low-density lipoprotein cholesterol (LDL-chol), apolipoprotein B (apoB) and Lp(a) levels and in the presence of apo E/E3 allele, only Lp(a) levels were determined as risk factors. Conclusion: This study showed that while apoE polymorphism was not a risk factor itself, high Lp(a), LDL-chol and apoB were determined to be risk factors in E3 or E4 carriers. © 2008 Elsevier B.V. All rights reserved.

Objectives: Biering-Sorensen test is an isometric back endurance test. Biering-Sorensen test scores have varied in different cultural and occupational groups. The aims of this study were to collect normative data on Biering-Sorensen holding times, to determine the discriminative ability of the Biering-Sorensen test in Turkish coal miners, and to examine the association between Biering-Sorensen test result and functional disability. Methods: One hundred and fifty male coal miners participated in this study. Trunk extensor muscle strength was measured using the Biering-Sorensen test. Oswestry disability index was used to measure the functional disability level of low back pain. Results: The mean Biering-Sorensen holding time for the total subject group was 107.3 ± 22.5 s. The mean time of Biering-Sorensen test of the subjects with and without low back pain were 99.9 ± 19.8 and 128.6 ± 15.2 s, respectively. The difference between the subjects with and without low back pain was statistically significant (p < 0.001). There was a statistically significant negative correlation between Oswestry functional disability score and Biering-Sorensen holding time (r = -0.824, p < 0.001). Conclusions: Turkish coal miners have low mean back extensor endurance holding times. Biering-Sorensen test had a good discriminative ability in our study group. Trunk muscle strength has a significant effect on the disability level of low back pain. Thus trunk muscle endurance training exercise therapy may be effective for the reduction of disability in patients with low back pain. © 2008 Société Française de Rhumatologie.

Objective: The aim of this study was to assess the psychometric details of the Turkish version of the Parenting Stress Index/Short Form (PSI/SF). Material and Methods: PSI/SF was administered to 90 mothers of children with congenital heart disease in the cardiology outpatient clinic. In 51 mothers the scale was re-administered 2 months later. Psychometric testing was carried out by using Cronbach's alpha, item-total correlations, test-retest reliability and validity. The concurrent validity of the instrument was established by correlating test scores with scores from 2 other well-known depression inventories (Beck and Zung Depression inventories). Results: Psychometric analysis showed that the Turkish version of the PSI/SF demonstrated satisfactory internal consistency (Cronbach's alpha) for Total Stress Score (0.71) and also for subscales including Parental Distress (0.81), Parent-Child Dysfunctional Interaction (0.76) and Difficult Child (0.78). Test-retest correlations (r= 0.88) indicated good stability over a mean time period of two months. The PSI/SF was in good correlation with Beck Depression (r= 0.77) and Zung Depression (r= 0.69) inventories. Conclusion: PSI/SF is an appropriate tool for measuring parenting stress in Turkish mothers of children with congenital heart disease and has cross-cultural validity.

Purpose. Surgeon inexperience has been defined as a significant predictor of deleterious outcome in thyroid surgery; however, the safety of training programs in which residents are the primary surgeons is controversial. The objective of this prospective study was to compare the complication rates of total thyroidectomy (TT) performed by residents with those of TT performed by specialist surgeons in similar patient groups. Methods. Between April 2001 and May 2007, 144 patients underwent TT at our hospital. For 75 operations, the primary surgeon was a resident under the direct supervision of the attending surgeon, and for 69 operations, the primary surgeon was the experienced attending surgeon. Pre-and postoperative vocal cord examinations and serum calcium level evaluations were carried out in all patients. Results. The rates of temporary (unilateral) recurrent laryngeal nerve (RLN) palsy were 2.66% vs 2.17% after TT performed by the residents vs the attending surgeon, respectively. There were no significant differences in the incidences of temporary hypoparathyroidism (20% vs 20.28%), permanent (unilateral) RLN palsy, hematoma, infection, seroma, and incidental parathyroidectomy between the two groups. Conclusion. The complication rates of TT performed by residents and attending surgeons were similar. Thus, residents can perform TT safely and effectively under the direct supervision of a senior surgeon. Ultimately, strict adherence to the contemporary principles of thyroid surgery is of paramount importance. © 2008 Springer.

WOS: 000255955700024, PubMed: 17932755, Introduction Sildenafil both enhances vasodilatation by relaxing the smooth muscle in the vessels and inhibits platelet aggregation. We have therefore examined the potential benefits of sildenafil on an animal model for ischemic colitis (IC). Methods Twenty-eight female Wistar albino rats weighing 250-300 g were randomized into three experimental groups as follows: in Group 1, animals were sham operated (n = 8) and received tap water; in Groups 2 and 3, the rats underwent a standardized surgical procedure to induce IC (n = 10 in each group). Group 2 animals served as the controls, receiving only tap water, while Group 3 animals received 10 mg/kg sildenafil per day as a single dose for a 3-day period. All animals were sacrificed 72 h after devascularization. To determine the severity of the ischemia, we scored the macroscopically visible damage, measured the ischemic area and scored the histopathology. Tissue malondialdehyde levels were also evaluated. Results The mean area of ischemic changes were 116.80 +/- 189.93 and 0.55 +/- 1.01 mm(2) in Group 2 and 3 animals, respectively (p = 0.0001), while the macroscopically mean visible damage score decreased to 0.66 +/- 0.70 (p = 0.0001) for Group 3 animals. The Chiu scores were 0.00, 3.80 +/- 0.91 and 2.66 +/- 1.00 in Group 1, 2 and 3 animals, respectively. There was a statistically significant difference between Group 2 and 3 animals (p = 0.017). Conclusions Our findings support the view that sildenafil leads to a improvement in IC due to its well-known effects on the vascular smooth muscle and on the microcirculatory hemodynamics.

Purpose: To examine whether polymorphisms of the interleukin 1 receptor antagonist (IL1RN), interleukin 1 alpha (IL1A) and interleukin 1 beta (IL1B) genes are markers of genetic susceptibility to knee osteoarthritis in Turkish patients. Methods: One hundred and seven patients with knee osteoarthritis and 67 controls were studied. Three polymorphisms of IL1A, IL1B, and IL1RN genes were typed from genomic DNA. Allelic frequencies were compared between patients and control subjects. Results: No significant differences were observed in genotype and allele frequencies of the IL1RN VNTR, IL1A+4845, IL1B+3953 genes polymorphisms between patients and controls. Furthermore, we did not detect any association genotypes of the polymorphisms with the clinical, radiological, and laboratory profiles of patients. Conclusions: The present study suggest that the IL1RN VNTR, IL1A+4845, IL1B+3953 genes polymorphisms are not genetic markers of susceptibility to knee osteoarthritis in Turkish patients, and are unrelated to the clinical, radiological, and laboratory characteristics of knee osteoarthritis.

The aim of our study was to investigate the effects of long-term (45 days) magnetic field (50 Hz, 1 mT; MF) on femur biomechanical parameters of rats. Bone mineral density (BMD) and histological investigation were also evaluated. For this purpose, twenty-four 8-week-old, Wistar-Albino female and male rats were assigned randomly to female control (FC) and MF-exposed rats (F-MF); male control (MC) and MF-exposed rats (M-MF). BMD was measured by dual-energy X-ray absorptiometry. Cross-sectional area of the femoral shaft was evaluated by computerized tomography. Biomechanical measurements were performed at the mid-diaphysis of the left femur with tensile test. Maximum load, displacement, stiffness, energy absorption capacity (structural properties); ultimate stress, ultimate strain, elastic modulus and toughness (material properties) were calculated. Diaphysial cortical bone thickness was measured by using histological method from the right femur. In respect to the cortical thickness of the rats' femurs, there was statistically significant interaction between the gender and group (P < 0.05), while the BMD and cortical area were not (P > 0.05). The BMD, cortical thickness and area values of the femurs of MF-exposed rats (F-MF, M-MF) were significantly decreased in comparison to that of the controls (FC, MC) (P < 0.05). There were no statistically significant differences between the control and the MF-exposed rats in respect to the femur length (P > 0.05). There were no statistically significant interaction between the gender and group with regard to the maximum load, displacement, stiffness, ultimate stress, ultimate strain, elastic modulus and toughness endpoints, while the energy absorption capacity was significant (P < 0.05). Maximum load, displacement and stiffness values of MF-exposed rats were significantly decreased compared to that of the controls (P < 0.05). Femurs of M-MF rats had less absorbed energy than that in controls (P < 0.05). Ultimate stress and elastic modulus parameters were significantly decreased in MF-exposed rats in comparison to that of the controls (P < 0.05). Ultimate strain was higher in MF-exposed rats than that in controls (P > 0.05). The mean of toughness was decreased in MF-exposed rats compared to that of the controls (P > 0.05). In conclusion, the bone quality of rats is decreased by magnetic field exposure. © 2007 Elsevier Inc. All rights reserved., Firat University Scientific Research Projects Management Unit, This work has been supported by the grants from the Mersin University Scientific Projects Unit (BAP.SBE.BIF.(SG)/2003-2 YL).

WOS: 000251840200007, PubMed: 18069756, AIM: To investigate the effect of exogenous erythropoietin (EPO) administration on acute lung injury (ALI) in an experimental model of sodium taurodeoxycholate-induced acute necrotizing pancreatitis (ANP). METHODS: Forty-seven male Wistar albino rats were randomly divided into 7 groups: sham group (n = 5), 3 ANP groups (n = 7 each) and 3 EPO groups (n = 7 each). ANP was induced by retrograde infusion of 5% sodium taurodeoxycholate into the common bile duct. Rats in EPO groups received 1000 U/kg intramuscular EPO immediately after induction of ANP Rats in ANP groups were given 1 mL normal saline instead. All animals were sacrificed at postoperative 24 h, 48 h and 72 h. Serum amilase, IL-2, IL-6 and lung tissue malondialdehyde (MDA) were measured. Pleural effusion volume and lung/body weight (LW/BW) ratios were calculated. Tissue levels of TNF-alpha, IL-2 and IL-6 were screened immunohistochemically. Additionally, ox-LDL accumulation was assessed with immune-fluorescent staining. Histopathological alterations in the lungs were also scored. RESULTS: The mean pleural effusion volume, calculated LW/BW ratio, serum IL-6 and lung tissue MDA levels were significantly lower in EPO groups than in ANP groups. No statistically significant difference was observed in either serum or tissue values of IL-2 among the groups. The level of tumor necrosis factor-alpha (TNF-alpha) and IL-6 and accumulation of ox-LDL were evident in the lung tissues of ANP groups when compared to EPO groups, particularly at 72 h. Histopathological evaluation confirmed the improvement in lung injury parameters after exogenous EPO administration, particularly, at 48 h and 72 h. CONCLUSION: EPO administration leads to a significant decrease in ALI parameters by inhibiting polymorphonuclear leukocyte (PMNL) accumulation, decreasing the levels of proinflammatory cytokines in circulation, preserving microvascular endothelial cell integrity and reducing oxidative stress-associated lipid peroxidation and therefore, can be regarded as a cytoprotective agent in ANP-induced ALI. (c) 2007 WJG. All rights reserved.

PubMed ID: 24533613 Background: Surgery of thoracoabdominal aortic aneurysms (TAAA) is associated with high incidence of serious complications. Ischemia/reperfusion (I/R) injury may be responsible for these complications. We investigated the effect of degree of anticoagulation on remote organ I/R injuries and whether heparin is protective against I/R injury in addition to its anticoagulant properties.Methods: Spraque Dawley rats were used to determine both liver and kidney concentrations of HSP-70,IL-6, MPO in four groups: ischemic control (operation with cross-clamping and intraperitoneal administration of 0.9% saline, n = 7), sham (operation without cross-clamping, n = 7), heparin (ACT level about 200), and high dose heparin (ACT level up to 600). Histological analyses of the organs were performed.Results: Histopathological evaluation of kidney presented significant differences between groups with regards to the cytoplasmic vacuole formation, hemorrhage, tubular cell degeneration and tubular dilatation while heparinized group had best results. The kidney MPO and HSP-70 levels significantly decreased (p < 0.05), but IL-6 level was not significant (p > 0.05) in heparinized group when compared to ischemic control group. No statistically significant intergroup differences were detected in the tissue samples of liver. Immunohistochemical markers of the liver were compared and no statistically significant difference was found among the groups.Conclusion: Heparin is an important anticoagulation agent in TAAA surgical procedures but the use of higher levels of heparin in the present study revealed no beneficial effects. Bleeding complications is much less when heparin is used in the real-world clinical practice as ACT levels of 200. © 2014 Yener et al.; licensee BioMed Central Ltd.

[No abstract available]

WOS: 000325901500013, Objective: The exposure to negative acts at work is one of the main issues highlighted adverse health effects within the scope of work life's psychosocial dimension. Mobbing is defined as both the most common one among the causes of stress being at work, and also more devastating and damaging than the other stressors of the work. The aim of the present study was to examine the reliability of the Turkish version of the Negative Act Questionnaire (NAQ-TR). Methods: The questionnaire was first translated into Turkish and then back translated into English and the equivalence of both versions was determined. An expert group analyzed the formulation of the translated items and they redrafted some of them according to agreedon criteria. Subsequently, it was administered to 456 workers from 11 different workplaces. The factor structure and internal consistency of the NAQ-TR was examined. Result: The instrument showed satisfactory internal consistency with an overall Cronbach a of 0.912. The factor analysis, as opposed to the original scale, yielded four factor solution (Personal bullying and isolation, Work-related bullying, destabilization and excessive workload). We found that NAQ-TR has high internal consistency. Conclusions: The Turkish version of NAQ was found to be reliable for mobbing in workplace. It can be used in epidemylogic trials.

Objective Revealing of unknown adverse effects of atypical antipsychotics on pediatric population may take a long period of time. The purpose of this prospective study is to document changes in the liver function tests (LFTs) associated with risperidone usage in a group of children and adolescents. Method Study subjects consist of 120 youths with ages ranging from 3–17 years. For this study, patients' baseline and follow-up weight and hepatobiliary function tests including alanine aminotransferases(ALT) and aspartat aminotransferases (AST), gamma gluatamyl transerase (GGT), alkaline phosphatase (ALP) and serum bilirubin levels were measured before and after the treatment period of one month. Results Only one male patient's ALT levels increased up to three-fold and AST levels increased up to two-fold of the basal levels. First month mean levels of liver enzymes and billuribin of the patients were significantly higher than the baseline. Sixty-three patients (52.5%) showed an asymptomatic increase in the liver enzymes and/or billuribin levels of the first month of this study. Weight gain was observed in 58 patients (57.4%). There was no significant association between changes in weight and liver enzymes and billuribin levels. Conclusion We found clinically non significant liver function test abnormalities mostly in the form of ALP elevation in 52.5% and marked liver enzymes elevation in 0.8% of risperidone-treated subjects. However use of concomitant medications and variations in age are the limitations of this study. These findings suggest that risperidone treatment in the short term may lead to liver function changes in children and adolescents.

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Bugdayci, Guler/0000-0002-4060-3354; SOY, MEHMET/0000-0003-1710-7018 WOS: 000328085300008 PubMed: 24302182 AIM: We investigated whether there was a significant increase in thyroid autoimmunity in patients with Familial Mediterranean fever (FMF). PATIENTS AND METHODS: In total, 220 patients, consisting of 42 with FMF, 75 with rheumatoid arthritis (RA), and 103 healthy controls, were enrolled. Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid autoantibodies (anti-thyroid peroxidase and anti-thyroglobulin) were measured in all participants. RESULTS: After adjustment for age, gender, and smoking status, statistically significant differences between serum levels of anti-thyroglobulin antibody, anti-thyroid peroxidase antibody, and fT3 were found between the groups (all p < 0.001). Serum TSH level did not differ between the groups (p > 0.05). The frequency of autoimmune thyroiditis in FMF group is higher than control group. However, this difference did not reached the level of statistical significance (p > 0.05). CONCLUSIONS: Although statistically not significant, thyroid autoimmunity was observed more frequently in patients with FMF than in healthy controls. Thyroid autoantibodies were significantly higher in patients with FMF. Studies with greater number of patients are required for evaluating the frequency of the autoimmune thyroiditis in patients with FMF.

Objectives: We examined the test properties about mean and mean differences, sampling distributions properties of mean and standard deviation, especially when the sample size is lower than 10 and the variable has normal distribution in population. In addition, we aimed to construct a 95% bootstrap confidence interval for skewness and kurtosis values in various samples sizes. Materials and Methods: In our simulation study, 10,000 samples with replacement were taken from the standard normal population. Various sample sizes were evaluated. Data which were obtained from an animal study were used for comparison of t-test's and Wilcoxon sign test's power in small sample. Results: According to our results, sampling distribution of skewness coefficients has normal distribution; however, kurtosis coefficients have positively skewed distribution. A bootstrap confidence interval for these coefficients by using these sampling distribution can be used for normality test. Moreover, it was shown that test statistic for the mean has t-distribution in all studied sample sizes. Conclusion: We can say that distribution shape of the variable plays a more important role than sample size in selection of appropriate test statistic. Turkish Başlık: Normal Dağılımdan Alınan Küçük Örneklerde Çarpıklık ve Basıklık için Bootstrap Güven Aralığı ve t-testinin Özellikleri Anahtar Kelimeler: Küçük örnekler; bootstrap simülasyon; t-testinin gücü; güven aralığı; çarpıklık ve basıklık katsayıları Amaç: Normal dağılımdan alınmış ve özellikle örnek genişliği 10'dan küçük olan örneklerden hesaplanan ortalama ve standart sapmanın örnekleme dağılımları ve ortalamaya ait hipotez testinin özellikleri incelenerek yine bu örneklerde çarpıklık ve basıklık katsayılarına ait %95 ihtimalli bootstrap güven aralıklarının oluşturulması amaçlanmıştır. Gereçler ve Yöntemler: Yapılan simülasyon çalışmasında standart normal dağılım gösteren popülasyondan geri iadeli olarak 10 000 örnek alınmıştır. Farklı örnek genişlikleri incelenmiştir. Küçük örnekte Wilcoxon işaret testi ve t-testinin güçlerini karşılaştırmalı olarak göstermek için bir hayvan deneyinden alınan veriler kullanılmıştır. Bulgular: Elde edilen bulgular değerlendirildiğinde, çarpıklık katsayısının örnekleme dağılımı normal dağılım olarak bulunurken, basıklık katsayısının pozitif çarpık bir dağılımı olduğu görülmüştür. Bu katsayıların örnekleme dağılımları kullanılarak bulunan bootstrap güven aralığı verilerin normallik testinde kullanılabilir. Bunun ötesinde örnek genişliklerinin tamamında ortalamaya ait test istatistiğinin t-dağılımına sahip olduğu görülmüştür. Sonuç: Uygun test istatistiğinin seçiminde verilerin dağılım şeklinin, örnek genişliğine göre daha önemli role sahip olduğu söylenebilir., Amaç: Normal dağılımdan alınmış ve özellikle örnek genişliği 10’dan küçük olan örneklerden hesaplanan ortalama ve standart sapmanın örnekleme dağılımları ve ortalamaya ait hipotez testinin özellikleri incelenerek yine bu örneklerde çarpıklık ve basıklık katsayılarına ait %95 ihtimalli bootstrap güven aralıklarının oluşturulması amaçlanmıştır. Gereçler ve Yöntemler: Yapılan simülasyon çalışmasında standart normal dağılım gösteren popülasyondan geri iadeli olarak 10 000 örnek alınmıştır. Farklı örnek genişlikleri incelenmiştir. Küçük örnekte Wilcoxon işaret testi ve t-testinin güçlerini karşılaştırmalı olarak göstermek için bir hayvan deneyinden alınan veriler kullanılmıştır. Bulgular: Elde edilen bulgular değerlendirildiğinde, çarpıklık katsayısının örnekleme dağılımı normal dağılım olarak bulunurken, basıklık katsayısının pozitif çarpık bir dağılımı olduğu görülmüştür. Bu katsayıların örnekleme dağılımları kullanılarak bulunan bootstrap güven aralığı verilerin normallik testinde kullanılabilir. Bunun ötesinde örnek genişliklerinin tamamında ortalamaya ait test istatistiğinin t-dağılımına sahip olduğu görülmüştür. Sonuç: Uygun test istatistiğinin seçiminde verilerin dağılım şeklinin, örnek genişliğine göre daha önemli role sahip olduğu söylenebilir.

WOS: 000471264700012 PubMed: 31189291 Objective: To investigate the susceptibility and specificity of the phenotypic methods to determine plasmid-mediated AmpC. Methods: The cross-sectional study was conducted at Duzce University Faculty of Medicine, Microbiology Laboratory from January 2015 to June 2016, and comprised Escherichia coli and Klebsiella pneumonia isolates intermediate susceptible or resistant to cefoxitine. Combined disk diffusion test, double disc synergy test, agar gradient test and polymerase chain reaction were used to detect plasmid-mediated AmpC. Results: Of the 2024 E. coli samples, 44(2.17%), and of the 792 K. pneumoniae samples, 16(2%) were included. Combined disk diffusion test had susceptibility of 68% and specificity of 50%; double disc synergy test 24% and 82%; and agar gradient test 40% and 68%. Of the isolates positively detected by polymerase chain reaction method, more than one gene region positivity was detected in 15(25%) isolates. Conclusion: All three phenotypic methods were found to be insufficient to detect plasmid-mediated AmpC positivity. Research Fund of Duzce UniversityDuzce University The Research Fund of Duzce University.

To study the association between TNFalpha-308 G/A polymorphism and susceptibility to and severity of knee osteoarthritis in a Turkish population.Genomic DNA was obtained from 151 patients with knee osteoarthritis and 84 ethnically matched healthy controls. Polymerase chain reaction-restriction fragment length analysis was used to identify G/A polymorphism at position -308 in the promoter region. Genotype distributions and allelic frequencies of TNFalpha-308 G/A polymorphism were compared between osteoarthritis patients and controls. Thereafter, this association was investigated between patients and controls of the same sex. In addition, the standard Kellgren-Lawrence grading score and the Turkish version of the Western Ontario and McMaster Universities Osteoarthritis Index were used to assess the radiological and functional severity of the disease and their relationship with the TNFalpha-308 gene polymorphism was investigated.Genotype distribution and allelic frequencies of -308 G/A polymorphism in the TNFalpha gene did not differ significantly between patients with knee osteoarthritis and controls (p0.05). Moreover, there were no significant differences between patients and controls of the same sex (p0.05). In addition, no association was observed between the radiological and functional severity of the disease and TNFalpha-308 G/A polymorphism (p0.05).These findings suggest that the examined polymorphism in the TNFalpha gene does not contribute to susceptibility to or severity of knee osteoarthritis in the Turkish population.

Purpose: Groin hernia repair is one of the commonest operations in surgical practice. The aim of this study was to find out if there is any difference between patients living in a rural area and those living in an urban area in terms of preferred type of anaesthesia, patients' participation in decision making, and hospitalisation time. Methods: The records of patients that underwent an elective groin hernia repair between November 2001 and April 2006 were evaluated retrospectively. Preferred type of anaesthesia, hospitalisation time, and participation in the decision making were investigated in patients living in a rural and an urban area, in the northern Black Sea region of Turkey. We also investigated whether the patient's age and sex had any effect on these parameters. Results: A total of 206 patients underwent elective repair of groin hernia in a State Hospital. Mean postoperative time spent in hospital was significantly longer for patients living in the rural area than for those living in the urban area. The hospitalisation time was longer for male than for female patients. Local anaesthesia was the preferred type of anaesthesia for the elderly. Older patients and villagers mostly preferred the physician to make the final decision about their treatment and they had longer hospital stays. Conclusion: Mean hospitalisation time was longer for patients living in the rural area and for male patients than for female patients. Younger patients and city dwellers preferred to make their own decision about their treatment and they had shorter hospital stays.

Objective: Although there is a healthy trend toward employment of multivariate analysis of variance (MANOVA) in the analysis of data from experiments which involve multiple dependent variables, there remains a need to demonstrate the wide variety of data analytic techniques available for post hoc analysis of statistically significant multivariate results. As a post-hoc test, using Stepdown Analysis after MANOVA was explained with application in this study, Material and Methods: In this study, the data set were used that contain 19 healthy (control group) pregnant, 21 pre-eclamptic pregnant and 11 eclamptic pregnant, who submitted to Obstetric and Gynecologist Department of Research Hospital of Y. Y. University Medical School between 2004-2005 years. Urinary protein, systolic blood pressure, lactate dehydrogenase, alanine amino transferase, aspartat transaminase, malonyl dialdehyde and platelets measurements were measured from pregnants. Results: It showed that urinary protein, systolic blood pressure and LDH were affected on groups' differences according to results of Stepdown analysis. Conclusion: Stepdown analysis, a test for the incremental discriminatory power of a dependent variable after the effects of other dependent variables has been taken into account. This analysis is similar to stepwise regression or discriminant analysis in that it relies on a specific order of entry to determine how much an additional dependent variable adds to the explanation of the differences between the groups in the MANOVA analysis. Because of this properties, Stepdown analysis is a suitable post-hoc tes for MANOVA. Copyright © 2007 by Türkiye Klinikleri.

Ankarali, Handan Camdeviren/0000-0002-3613-0523 WOS: 000343068800023 PubMed: 25539557 Aim: Findings from clinical studies in postmenopausal women with late initiation of hormone replacement therapy (HRT) that test whether HRT protects cognitive functions in women are inconsistent. The aim of this study was to investigate the effects of HRT on brain metabolite ratios when initiated in the early postmenopausal period (critical window). Materials and methods: Proton magnetic resonance spectrometry (1H MRS) was performed in 4 brain regions of 47 healthy postmenopausal women (21 received HRT, 26 did not). The subjects were aged between 45 and 65 years. The duration of HRT ranged from 1 to 12 years (mean: 6.3 years). The duration of menopause was 2-12 years (mean: 6.1 years) for HRT users and 1-20 years (mean: 7.8 years) for non-HRT users. Metabolite ratios [N-acetyl aspartate/choline (NAA/Cho), NAA/creatine (Cr), and Cho/Cr] were evaluated. Results: Cho/Cr ratios were significantly increased and NAA/Cho ratios significantly decreased in all 4 regions in the HRT user group compared to the other group after elimination of the effects of age and menopause duration. Regression analysis revealed an association only between NAA/Cho and duration of menopause. Conclusion: HRT-related changes in metabolite ratios are found in all brain regions. Decreased NAA/Cho and increased Cho/Cr levels do not support the neuroprotective role of HRT in the critical window.

WOS: 000275932000006, Background: Glucocorticoid treatment is recommended as the first-line treatment of MS relapses, however there is still no clear evidence supporting an optimum therapeutic regime. The high dose (HD) consisted of at least 500 mg/day, but the total dose of intravenous MP administered and the regimen varied among studies. The aim of this study was to assess the improvement following a standard regime of IVMP (1 g/day MP given for 10 days, without tapering) for MS relapses. A second objective was to search baseline predictors of outcome. Method: Consecutive treatments with IVMP for ten days (I g/day, single dose in 150 cc. saline, over 40 min) administered at our Neurology clinic for an episode of acute neurological deterioration in 44 patients (55 relapses) diagnosed with RR MS were recruited. retrospectively. Results: Attack severity was mild in three, moderate in 28 and severe in 24 relapses. Significant improvement (>= 1.0 EDSS point) Occurred in 81% of attacks at one month. The rate of improvement at ten days was 83.6%, and 85.5% at six months. There was no difference in means of latency to treatment between the patients that responded well to therapy and responded poor, at the first month. However response to therapy was higher at the sixth month in patients with latency to treatment shorter than fifteen days (68.4 %, 94.4 %). Conclusions: In conclusion the results of our retrospectively designed clinical study support that HD NIP, 1 g/day for ten days administered IV can accelerate the recovery from MS relapses. This regimen with proper early timing for starting therapy might determine the optimum benefit.

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Ersoy Karka, Ozlem/0000-0001-7309-427X; Yorulmaz, Ilknur Suidiye/0000-0002-1441-6360 WOS: 000346935200001 PubMed: 25550680 Background: Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients. Methods: One-hundred-forty female, normotensive or hypertensive patients undergoing myomectomies or hysterectomies. They were randomly enrolled into the subgroups: Group ND (normotensive-dexmedetomidine); Group HD (hypertensive-dexmedetomine); Group NM (normotensive-midazolam); Group HM (hypertensive-midazolam). Dexmedetomidine was administered at a concentration of 0.5 mu g.kg(-1), and midazolam was administered at a concentration of 0.025 mu g.kg(-1) via intravenous (IV) infusion before the induction of anaesthesia. Haemodynamic parameters were recorded at several times (T-beginning, T-preop5 min, T-preop 10 min, T-induction, T-intubation, T-intubation 5 min, T-initial surgery, T-surgery 15 min, T-surgery 30 min, T-extubation, T-extubation 5 min). Propofol amount for induction, time between induction and initial surgery, demand of antihypertensive therapy, rescue atropine were recorded. Quantitative clinical and demographic characteristics were compared using One Way ANOVA. The values were compared using One-way Analysis of Variance. Additionally periodic variations were examined by One way Repeated Measures Analysis of Variance for groups separately. Results: SBP was significantly different between normotensive and hypertensive groups at the following time points: T-preop 5 min, T-preop 10 min, T-induction, T-intubation, T-intubation 5 min and T-initial surgery. MBP was significantly different in the hypertensive groups at T-induction, T-intubation, T-intubation 5 min, T-initial surgery, T-surgery 15 min, T-surgery 30 min, T-extubation and T-extubation 5 min. The perioperative requirements for antihypertensive drugs were significantly higher in Group HM. Conclusion: In the hypertensive patients, dexmedetomidine premedication provides better hemodynamic stability compared with midazolam, and because it decreases the antihypertensive requirements, its use might be beneficial. Duzce University's Projects Support Fund for Scientific ResearchDuzce University This study was financed by Duzce University's Projects Support Fund for Scientific Research.

Ankarali, Handan Camdeviren/0000-0002-3613-0523 WOS: 000285732000007 PubMed: 21140113 Introduction: The Shoulder Pain and Disability Index (SPADI) is a valid and reliable questionnaire used in shoulder disorders. The purpose of this study was to test the convergent validity and the reliability of the SPADI. Methods: A total of 101 female patients with shoulder pain were enrolled in the study. The SPADI and the Health Assessment Questionnaire (HAQ) were completed by all the participants. Pain was measured using the Visual Analogue Scale (VAS) during the active range of motion. Reliability was measured by internal consistency and test-retest reliability. Internal consistency was determined by calculating Cronbach's alpha value. Convergent validity was examined by correlating the SPADI questionnaire with the VAS and HAQ scales. Results: Cronbach's alpha value for the SPADI was found to be 0.94. Test-retest reliability of the SPADI was found to be high (0.92). The correlation coefficient for convergent validity of the SPADI was 0.65 and 0.67 for the VAS and HAQ overall scores, respectively. Conclusion: The results of the present study suggest that the SPADI is a valid and reliable instrument to assess shoulder pain in Turkish female patients.