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Hyperbaric oxygen treatment (HBOT) can be utilised for necrotising soft tissue infections, clostridial myonecrosis (gas gangrene), crush injuries, acute traumatic ischaemia, delayed wound healing, and compromised skin grafts. Our case was a 17-month-old male patient with Noonan syndrome, idiopathic thrombocytopenic purpura, and bilateral undescended testicles. Haematoma and oedema developed in the scrotum and penis the day after bilateral orchiopexy and circumcision. Ischaemic appearances were observed on the penile and scrotal skin on the second postoperative day. Enoxaparin sodium and fresh frozen plasma were started on the recommendation of haematology. Hyperbaric oxygen treatment was initiated considering the possibility of tissue necrosis. We observed rapid healing within five days. We present this case to emphasise that HBOT may be considered as an additional treatment option in patients with similar conditions. To our knowledge, no similar cases have been reported in the literature., Competing Interests: The authors report no conflicts of interest in this work., (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)

Background: The treatment of persistent syringomyelia associated with Chiari malformation type 1 (CM1) is unclear. This study aims to evaluate the clinical and radiologic outcomes of syringo-subarachnoid shunt (SSS) as a treatment for persistent syringomyelia following posterior fossa decompression (PFD) for CM1., Methods: Forty-nine cases treated for CM1 associated syringomyelia at a single center were analyzed, 17 of them undergoing reoperation due to persistent syrinx formation. The patients' demographic data, neurologic presentations, and radiologic results were analyzed, including cerebellar herniation, posterior fossa volume, the level at which the syrinx started and finished, the size and diameter of the syrinx., Results: Seventeen patients underwent SSS placement, with 1 minor surgical complication (a cerebrospinal fluid leak) occurring and requiring revision. No morbidity or mortality was observed. Among these 17 reoperated patients, partial or complete resorption of the syrinx was observed in all cases. The results suggest that if the syrinx diameter is >10 mm at its thickest point, extends for more than 10 vertebrae, and starts from the upper cervical region and extends to the upper thoracic region, the syrinx may not regress after the first surgery and potentially predicting the need for a second operation before PFD., Conclusions: SSS placement for persistent syrinx following PFD for CM1 is a safe and effective surgical treatment method. These criteria may also help predict the need for a second surgery and the overall disease outcome for both the surgeon and patient., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The present study deals with the diversity of the genus Levinsenia in the Sea of Marmara. The specimens of Levinsenia were collected on soft and hard substrata at depths ranging from 10 to 500 m at 98 stations in 2013. Among the material, two new species, namely Levinsenia longobranchiata n. sp. and L. vulgaris n. sp., and five already known species (L. demiri, L. kosswigi, L. materi, L. marmarensis, L. tribranchiata) were found. Levinsenia longobranchiata n. sp. is mainly characterized by having very long branchiae (longer than the body width) and five prebranchial chaetigers without notopodial postchaetal lobes. Levinsenia vulgaris n. sp. is mainly characterized by having short branchiae (shorter than the body width) and five prebranchial chaetigers with notopodial postchaetal lobes. The SEM images enabled us to define some previously neglected/indistinct characters in the taxonomy of Levinsenia such as the degree of the fusion of the branchiae with the notopodia; the morphology of dorso-lateral irregular pores, cheek organ, ciliated patches and lateral organs on the lateral sides of the prostomium; and the shape and distribution of the lateral sense organs along the body. All species found in the region were presented and described, by also taking these novel characters into account.

This paper reports 13 Aricidea species from the Sea of Marmara. The Aricidea specimens were collected at 98 stations in the region in 2012 and 2013 from soft and hard substrata at depths ranging from 0 to 1200 m. Among the material, two new species, namely Aricidea (Acmira) katzmanni n. sp. and Aricidea (Acmira) pseudoassimilis n. sp., and 11 known species were discovered. Aricidea mirunekoa and A. bulbosa are new records for the Mediterranean fauna; A. (Acmira) annae and A. (Aricidea) wassi are new records for the Sea of Marmara. Aricidea (Acmira) katzmanni n. sp. is characterized by having a long, digitiform antenna; no notopodial papillae on the posterior part of the branchial region; and hook shaped modified neurochaetae with a strong hood and fragile arista. Aricidea (Acmira) pseudoassimilis n. sp. is characterized by having a short, digitiform antenna; interramal lobes between notopodia and neuropodia; hook-shaped modified neurochaeta that gets subterminally thinner with a rounded tip. As A. (Strelzovia) bulbosa has been only previously reported from the Gulf of Suez (Red Sea), it could be a new alien species for the Sea of Marmara and Mediterranean Sea. Based on the characters that have been overlooked so far, the subspecies A. suecica meridionalis and A. capensis bansei were raised to species level, A. meridionalis n. stat. and A. bansei n. stat. The present paper reports the usage of ciliary bands and slits on the prostomium and body, swellings/ridges in the branchial region, and the shape and distribution of sense organs in the taxonomy of Aricidea. All species were described and figured.

The present study deals with the diversity of the genus Paradoneis (Annelida: Paraonidae) from the Sea of Marmara. Examination of materials collected from various soft and hard substrata from depths between 10 and 1200 m in the region revealed the presence of four species, among which one was already known from the region (P. ilvana), one was a new record for the Sea of Marmara (P. armata) and other two (P. heterochaeta n. sp. and P. longifurcata n. sp.) were new to science. Paradoneis heterochaeta n. sp. is characterized mainly by having a proportionately large size, by its pigmentation on the body, by bearing minute notopodial postchaetal lobes and by possessing two types of lyrate chaetae. Paradoneis longifurcata n. sp. is mainly characterized by having weakly jointed notopodial postchaetal lobes and lyrate chaetae with the long branch being up to 4.5 times longer than the short branch. All species found in the area are described and discussed.

This paper deals with specimens of Cirrophorus collected from the depths ranging from 3 to 500 m in 2012 and 2013 in the Sea of Marmara, Turkey. Among the material, one new species and two already known species were found. The new species is mainly characterized by having long and clavate notopodial postchaetal lobes in the branchial region; red speckles near nuchal organs; and a very long branch of lyrate chaetae (4 times longer than the shorter one). A recently described species, Cirrophorus nikebianchii, was found at the majority of soft-bottom stations. All species found in the area were described and discussed.

Polycystic ovary syndrome (PCOS) occurs in 5-10% of premenopausal women. Studies suggest that PCOS is associated with increased risk of coronary heart disease (CHD). To investigate this relationship, 15 PCOS women (group 1) and 10 healthy women (group 2) were studied. Blood leukocyte counts (white blood cells, WBC) and serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, sensitive C-reactive protein (sCRP), and neopterin were measured in the 2 groups. There were no significant differences in serum total cholesterol, HDL-cholesterol, or LDL-cholesterol concentrations between groups 1 and 2. Blood WBC counts and serum levels of neopterin and sCRP were significantly higher in group 1 than group 2. The median (min-max) levels were: WBC, group 1: 8.05 (5.10-9.70) cells x 10(9)/L, group 2: 6.25 (4.70-9.70) cells x 10(9)/L (p <0.01); neopterin, group 1: 10.6 (7.5-49.5) nmol/L, group 2: 9.6 (6.5-12.9) nmol/L (p < 0.05); and sCRP, group 1: 7.0 (1.2-12.0) mg/L, group 2: 2.0 (0.1-12.0) mg/L (p <0.01). This study shows that blood WBC counts and serum sCRP and neopterin levels are significantly elevated in women with PCOS. These findings support an increased risk for early-onset cardiovascular disease in women with PCOS. This is the first report that women with PCOS have higher serum neopterin levels than healthy women with regular menstrual cycles.

Background: Obesity and increased waist-to-hip ratio, emphasizing the importance of truncal obesity, have been found to correlate positively with increased cardiovascular disease risk and mortality. Owing to the inflammatory nature of atherosclerosis, the aim of our study was to find possible correlations between body mass index and waist-to-hip ratio, and the inflammatory markers C-reactive protein (CRP) and neopterin in healthy lean and overweight adults., Methods: A total of 49 healthy adults (mean age 42.4 +/- 1.8 years, 32 females and 17 males) were classified according to their body mass index (BMI) and waist-to-hip ratio values. CRP and neopterin levels were measured., Results: CRP levels were found to be significantly higher in the group with BMI > or = 25 kg/m2 compared to the group with BMI < 25 kg/m2 (p = 0.014). Subjects with increased waist-to-hip ratio displayed significantly higher serum CRP and neopterin levels (p = 0.014 and p = 0.033, respectively) compared with the group in which the waist-to-hip ratio was < 0.9. A strong positive correlation was found between CRP and BMI in the whole group (r = 0.658, p = 0.0001)., Conclusions: Grouping overweight subjects according to their waist-to-hip ratio, which is an indicator of truncal obesity, seems to be convenient in studying the inflammatory process in relation to the elevation of adipose tissue. Elevated CRP and neopterin levels may be useful in the assessment of cardiovascular risk in overweight as well as obese subjects.

We hypothesized that the administration of rosiglitazone, an insulin-sensitizing agent of the thiazolidinedione class, would improve the ovulatory dysfunction, hirsutism, hyperandrogenemia, and hyperinsulinemia of polycystic ovary syndrome (PCOS) patients. Forty women with PCOS and impaired glucose tolerance test (IGT) were randomly assigned to the 8-month treatment with rosiglitazone at either 2 mg/day or 4 mg/day. We compared changes in ovulatory function, hirsutism, hormonal levels (total and free testosterone, estradiol, estrone, androstenedione, LH and FSH), and measures of glycemic parameters (fasting and post-challenge levels of glucose and insulin, HOMA-IR, hemoglobin A1c), between the study groups. The patients' baseline characteristics were similar across all treatment arms. Fifteen of 20 women in the 2 mg group and 19 of 20 women in the 4 mg group achieved normal glucose tolerance; 14 of 20 women in the 2 mg group and 17 of 20 women in the 4 mg group achieved ovulatory menses at the end of the study period. The decreases of free testosterone levels were better in the 4 mg group than the 2 mg rosiglitazone group (-1.89+/-0.35 pg/ml vs. -2.21+/-0.39 pg/ml; P<0.01). There were neither any serious adverse events nor any liver enzyme elevations in our study patients during the treatment period. This study demonstrated that rosiglitazone improves the ovulatory dysfunction, hirsutism, hyperandrogenemia, and insulin resistance of PCOS in a dose-related fashion, with minimal adverse effects. This drug may be a good choice for lifetime treatment of patients with PCOS, especially for the ones who failed to show satisfactory results in metformin therapy.

The purpose of this study was to determine whether polycystic ovary syndrome (PCOS) and nonclassic 21-hydroxylase deficiency (CAH) are related to hyperhomocysteinemia, and to investigate if there is a correlation between homocysteine levels and insulin sensitivity in women with PCOS and CAH. Fifty patients with PCOS, 50 patients with CAH and 25 control women were included in the study. Blood samplings were performed in the early follicular phase for measuring hormone profile, Vitamin B(12), folate, homocysteine levels and fasting blood glucose. Ovulatory status was assessed with timed serum progesterone measurements. Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated as a measure of insulin resistance. Mean homocysteine levels were found as (8.9 + 1.9 micromol/l and 17.7 + 3.6 micromol/l) in the normal group and PCOS respectively (p<0.001), but there was no statistical significance between nonclassic 21-hydroxylase deficiency (9.0 + 2.2 micromol/l) and control group. Most of the patients in PCOS group (35 of 50) were significantly insulin resistant. However, there was no insulin resistant patient in CAH or control group. When we compare the two subgroups of PCOS women, the patients with insulin resistance had significantly higher homocysteine levels than the ones who were not insulin resistant. There were positive correlations among serum homocysteine, insulin and androgen levels in PCOS patients. There were no correlations among these parameters in CAH and control groups. Increased homocysteine levels may contribute to increased cardiovascular disease risk in patients with PCOS. The reason for hyperhomocysteinemia seems to be related to insulin resistance but not high androgen levels.

Platelet dysfunction and its association with insulin resistance and/or hyperandrogenemia were evaluated in 50 women with polycystic ovary syndrome (PCOS), 50 women with non-classic congenital adrenal hyperplasia (NC-CAH), and 30 women in the control group. Agonist-induced platelet aggregation was measured. Women with PCOS had significantly higher levels of platelet aggregations induced by ADP (77.4 +/- 3.3 vs. 67.3 +/- 2.8), collagen (79.7 +/- 1.8 vs. 69.1 +/- 3.9), and epinephrine (84.7 +/- 2.6 vs. 67.8 +/- 3.8), compared with controls. However platelet aggregations of women with NC-CAH because of ADP (68.2 +/- 4.22), collagen (69.5 +/- 5.4), or epinephrine (68.6 +/- 4.3) were similar to those in the control group. There were negative correlations between aggregations induced by agonists and the insulin sensitivity in women with PCOS. These correlations also appeared significant after androgen levels with covariance analysis were excluded. These covariance analyses were performed because serum androgen levels might affect platelet function. Any significant correlations were not found between androgen levels and agonist-induced platelet aggregation in women with NC-CAH. We conclude that platelet dysfunction may be an important reason for the possible cardiovascular heart diseases in women with PCOS.

Respiratory syncytial virus (RSV) infection was searched for in 65 children between 2 months and 2 years of age hospitalized with the presumptive diagnosis of acute bronchiolitis, and in 35 children aged 6 months to 8 years with upper respiratory tract symptoms, by direct fluorescent antibody (DFA) test and cell culture. RSV infection was detected in 29.2% of the first and in 11.4% of the second group. The overall positivity rate was 23%. The sensitivity and the specificity of the commercially available DFA test in comparison with cell culture were 81.8% and 92.5%, respectively.

Endocervical specimens obtained from 251 registered prostitutes working in a brothel in Izmir, were screened for Chlamydia trachomatis by using a direct fluorescent antibody test. Twenty seven of these specimens were excluded because of inadequate sampling. Of the remaining 224 samples, 57 (25.4%) were found positive for C. trachomatis. It is concluded that, prostitutes play an important role in the transmission of chlamydial and other sexually transmitted diseases, and routine screening and appropriate treatment of chlamydial infections in prostitutes will help to control this disease in the general population.

One hundred two patients with signs and symptoms of conjunctivitis and 45 asymptomatic subjects were screened for Chlamydia trachomatis using a direct fluorescent antibody test. 26.5% of the symptomatic and 6.6% of the asymptomatic patients were positive for C.trachomatis. The follicular response rate was significantly higher (p < 0.05) in the symptomatic group than in the asymptomatic population (48.1% and 29.3% respectively). This finding correlated well with chlamydial conjunctivitis.

Conjunctival scrapings from 24 women found to be positive for genital Chlamydia trachomatis previously and urethral swabs from their sexual partners were obtained and processed with direct fluorescent antibody technique. 8.3% of the conjunctival scrapings and 33.3% of the urethral specimens were found positive for C. trachomatis. None of the female patients had ocular complaints or signs of conjunctivitis and only two of the male subjects had urogenital symptoms.

A total of 160 endocervical specimens collected from 72 symptomatic and 82 asymptomatic women attending a gynecology outpatient clinic were investigated for genital Chlamydia trachomatis infection by the use of tissue culture and DFA test. The infection rate was 42% for symptomatic and 23% for asymptomatic patient groups. The sensitivity rates of the DFA test in the symptomatic and asymptomatic groups were 84% and 75%, while the specificity rates were 89% and 95%, respectively. The DFA test had an overall sensitivity of 80% and specificity of 93%. There was 90% agreement between the two techniques. Therefore, DFA is recommended as an alternative to tissue culture where laboratory facilities are limited and genital chlamydial infections are highly prevalent.

Urogenital Chlamydia trachomatis infections are the most common sexually transmitted diseases which have shown a significant increase in the last few years. This organism presents a major health problem in many countries. It is recognized as the cause of both complicated and uncomplicated infections in men, women and infants passing through an infected birth canal. Tissue culture is accepted as the gold standard in the diagnosis of chlamydial infections. But, since this technique is expensive and cumbersome, antigen detection tests such as DFA and EIA are more widely used. Tetracyclines and erythromycins are the first-choice antimicrobials in the treatment of chlamydial infections.