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Introduction: Our knowledge has gaps regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication levels and its association to severity of Coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the association of SARS-CoV-2 viral load with disease severity and serum biomarkers in COVID-19 patients. Methodology: Viral load was determined via cycle threshold (Ct) values of SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in 214 adult patients. Ct values were compared with clinical severity, biochemical and hematological biomarkers. Results: Clinical course of the disease was mild (49.1%), moderate (40.2%), and severe (10.7%). Median Ct value was 28.2 (IQR: 22.2–33.8) during the first week of the disease. Ct values were lower within five days after symptom onset [lowest Ct value on the third day (median: 24, IQR: 20.6–32.3)], but they increased significantly during the second and third weeks. No association was detected between admission Ct values and disease severity. Gender, age, co-morbidity, and mortality did not differ significantly in patients with low (≤ 25) and high (> 25) Ct values. White blood cell, neutrophil, platelet, and especially lymphocyte counts, were significantly lower in patients with low Ct values. Conclusions: No definitive/clear correlation between SARS-CoV-2 viral load and severity and mortality was found in the studied COVID-19 patients. However, neutrophil, platelet, and especially lymphocyte count were significantly lower in patients with a high viral load.

Purpose: To investigate the prevalence of overactive bladder (OAB) in patients with obstructive sleep apnea syndrome (OSAS) and the factors affecting it. Materials and methods: A total of 255 patients were included in this prospectively designed study. Among all patients, 166 were male, 89 were female; 213 patients were married and 42 were single. All patients underwent polysomnography. All patients completed the OAB-V8 form. OSAS was diagnosed via polysomnography. OAB was diagnosed via OABV8. The participants were evaluated as patients with and without OAB and those with and without OSAS. SPSS for Windows version 18.0 software was used for the statistical analysis and the level of significance was set at α = 0.05. Results: The prevalence of OAB was high among the OSAS patients (66.3%, n = 136). Age, body mass index, waist circumference, marital status, oxygen desaturation index (ODI4) ⩾4%, apneahypopnea index (AHI), the number and duration of decreases in O2 saturation below 90%, wake after sleep onset (WASO) duration, and groups, and OSAS severity were different in the OAB group ( p 2 saturation Conclusion: OAB is seen at a high rate in OSAS patients. Hypoxia is the main basis for both diseases and probably it is the common pathway. AHI, WASO, age, and marital status can provide valuable information to physicians for predicting OAB.

Objective Corpus callosum is the main structure that provides communication between the two brain hemispheres. This study aimed to investigate the differences in the shape of corpus callosum and cranium during growth and to assess their potential clinical implications. Methods Cranium and corpus callosum shape data were collected from two-dimensional digital images. Generalized Procrustes analysis was used to obtain mean shapes between consecutive age-groups. Shape deformation of the corpus callosum between consecutive age-groups was evaluated using the thin-plate spline method. Results There were significant age-based differences in the shape of carpos callosum and cranium. The most prominent deformation was seen in the posterior midbody (a region of the corpus callosum), while the greatest deformation in the cranium was observed in the biparietal area. There were significant differences in corpus callosum shape between 1- and 2-year age-groups. The diameter of the cranium increased up to the age of 4 years; however, this increase was not uniform, especially in the biparietal areas. Conclusions The growth of skull and the development of the corpus callosum are not similar. The development of corpus callosum may be a better indicator of neural development than skull enlargement.

Overactive bladder (OAB) is a common clinical problem with associated morbidities both in men and women. Although real-life management strategies have been examined among urologists (URO), treatment choices may differ between different specialties. In the present study, an online survey was conducted to determine and compare the management strategies and clinical preferences of UROs, obstetricians/gynecologists (OB/GYN), and geriatricians (GER) in the treatment of OAB in their daily practices.Between December 2020 and February 2021, an online questionnaire was sent to URO, OB/GYN, and GER specialists/residents. Current strategies and attitudes toward treatment of OAB in patientslt;65 years were compared between URO and OB/GYN, whereas the responses were compared between all three specialties in patients ≥65 years.A total of 733 specialists/physicians (433 URO, 236 OB/GYN, and 64 GER) completed the online survey. Patients with OAB were more likely to present to URO compared to OB/GYN and GER (p = 0.001). A combination of behavioral modification and pharmacotherapy (antimuscarinics and/or beta-3 agonists) were chosen for the initial treatment of patients with OAB in both specialties with a significantly higher proportion by URO than by OB/GYN (51.9% vs. 38.1%; p = 0.001). Antimuscarinics were the most frequently prescribed medications by both the URO and OB/GYN specialties (81.8% vs. 78.4%; p = 0.27). Combination therapy with antimuscarinics was preferred more often by URO (91.5% vs. 77.1%; p = 0.001) when no or an inadequate response after initial treatment occurred. Multiple medication use, comorbidities, and risk of cognitive side effects affected medication preference by all specialists, especially by GER (p = 0.018).Patients with OAB present to UROs, OB/GYN and GER more frequently compared to other specialities. Although antimuscarinics and beta-3 adrenoceptor agonists are equally recommended as first-line pharmacotherapy for OAB, antimuscarinics were preferred for most patients as the initial molecule by all specialties. Beta-3 agonists are increasingly preferred for elderly patients.

Background: Diagnosis of childhood pulmonary tuberculosis (TB) is often based on clinical features in combination with radiologic findings because of paucibacillary nature of the disease in children. It may be difficult to make a clinical diagnosis because of the overlapping clinical features of pulmonary TB and community-acquired pneumonia (CAP). On computed tomography (CT) scanning, the presence of typical LAP can suggest TB as a possible cause. Objectives: To compare the features of mediastinal LAPs between two patient groups based on contrast-enhanced chest CT. Methods: A total of 45 pulmonary patients with TB and 38 patients with CAP (aged ≤ 18 years) were enrolled in this retrospective study. The presence and CT features of lymph node involvement and the incidence of associating parenchymal/pleural findings were analyzed in two groups. Results: All patients with TB and 36 of the 38 patients with CAP had at least one mediastinal LAP. There was no significant difference between the two groups according to the incidence of lymph node and multiple site involvement and also involved lymph node stations (P > 0.05). However, lymph node size was larger in the TB group (P = 0.04). Twenty-two percent of patients with TB had mediastinal LAP without parenchymal/pleural involvement. Conclusions: Although the lymph node size was larger in TB group than in CAP group, CT features of mediastinal lymph node involvement overlapped between two groups. Nevertheless, mediastinal LAP without parenchymal/pleural involvement on CT is seen in a significant number of TB patients.

STAT3 plays an important role in various complex and sometimes contradictory pathways such as proliferation, differentiation, migration, inflammation, and apoptosis. The transcriptional activity of the STAT3 gene is controlled by a transcription factor called ZNF341. There is insufficient data on radiation sensitivity and post-radiation DNA repair in STAT3- loss-of-function (LOF) patients. We aimed to investigate the radiosensitivity in patients with STAT3-LOF and ZNF341 deficiency. Twelve patients with STAT3-LOF and four ZNF341-deficiency patients were recruited from three clinical immunology centers in Turkey and evaluated for radiosensitivity by the Comet assay, comparing to 14 age- and sex-matched healthy controls. The tail length (TL) (μm), percentage of DNA in the tail (TDNA%), and olive tail moment (OTM) (arbitrary units) were evaluated at the same time for baseline (spontaneous), initial (immediately after 2 Gy irradiation), and recovery (2 h after irradiation) periods by using a computerized image-analysis system, estimating DNA damage. Except for a patient with ZNF341 deficiency who developed nasal cell primitive neuroendocrine tumor and papillary thyroid cancer during the follow-up, there was no cancer in both groups. During the recovery period of irradiation, TL, TDNA%, and OTM values of healthy controls decreased rapidly toward the baseline, while these values of patients with STAT3-LOF and ZNF341 deficiency continued to increase, implying impaired DNA repair mechanisms. Increased radiosensitivity and impaired DNA repair were demonstrated in patients diagnosed with STAT3-LOF and ZNF341 deficiency, potentially explaining the susceptibility to malignant transformation.

Objectives: The present study, an international web-based survey, was focused on four aims: to obtain sports science professional’s self-reported statistical knowledge levels and how this knowledge varies by research area, to investigate and specify when statistics courses should be taught in sports science education and to identify the key statistical methods relevant to sports science education. Methods: In the present study, sports science professional data obtained by a web-based survey. Participants were selected randomly from the PubMed (www.ncbi.nlm.nih.gov) database for the years 2010-2018 using the keywords “school of sports science, faculty of sports science, sports faculty” by screening the sports science journals. Therefore, the participants were determined by searching the keywords in the corresponding or the first author’s address information of the articles. Results: The results indicate that while sports science professionals emphasize statistics education and the participants also believe that taking a statistics course is useful for their occupation. A statistics education should also emphasize the necessity of statistical consultation. Conclusions: Our study provides information regarding self-reported levels of statistical knowledge of sports science professionals by research area and academic position, and provides guidance regarding the ideal semester for administering a statistics course.

Background/aim: CAIPIRINHA is a new technique in abdominal imaging. Pancreatic steatosis PS is a subject of increasing scientific interest. The aim of this study was to investigate the efficacy of the isotropic 3D-VIBE- CAIPIRINHA -DIXON technique on a new generation 3-tesla MR unit in the evaluation of PS.Materials and methods: In this retrospective study, the imaging findings of 49 patients with PS and 41 control subjects were examined. The pancreas-to-spleen ratio PSR , pancreas-to-muscle ratio PMR , and pancreatic signal intensity index PSII were defined as 3 new parameters and these indexes were calculated from the in-phase/out of phase 3D-VIBE- CAIPIRINHA-DIXON images. Results: The PSR, PMR, and PSII values were significantly different between the patient and control groups P = 0.001, P = 0.009, P < 0.001, respectively . Statistically significant differences were observed between patient and control groups for ROI measurements of fatty areas on these sequences/images: subtraction in-out P < 0.001 , T2W HASTE P < 0.001 , DIXON-fat P < 0.001 , fat-suppressed T1W P = 0.002 , and subtraction out-in P = 0.010 . Conclusion: Evaluation of PS with the 3D-VIBE-CAIPIRINHA-DIXON technique can be made rapidly and effectively.

Surgery is the gold standard treatment for patients with scoliosis. Fusion and reconstruction of the spinal column is the preferred method for correction of scoliosis. This study aimed to investigate the preoperative and postoperative differences in the upper-body and spinal shapes of patients with scoliosis.Digitized two-dimensional X-ray images were used to obtain the shapes of the upper-body and spine. The preoperative and postoperative mean shapes were compared by using a Generalized Procrustes analysis. The thin plate spline (TPS) method was used to evaluate the spinal shape deformation between the preoperative and postoperative periods.The pre- and postoperative upper-body and spinal shape differences were significant. The TPS graphics showed high-level deformations between the pre- and postoperative periods. The left superior border of the L4 spinous process showed the highest deformation.The preoperative and postoperative upper-body and spinal shape differences and structural deformations that correlated with scoliosis were shown to be significant.

Introduction Vaccines have been shown to prevent illness, disability and death from vaccine-preventable diseases. The purpose of our study was to analyze the influenza and pneumococcal vaccination status of patients, the factors that influence the uptake of influenza/pneumococcal vaccination and the effects of health literacy (HL) on vaccination. Materials and methods In this cross-sectional study, demographic characteristics, comorbid diseases and the pneumococcal and influenza vaccination status in previous years were recorded for each patient. The Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to assess HL. Results A total of 350 patients were enrolled in the study. A total of 6.3% of patients had received both vaccines. 20% of subjects were vaccinated with influenza vaccine and 11.1% of the subjects were vaccinated with pneumococcal vaccine. Overall HL was insufficient for 70.9%, problematic for 20.6%, sufficient for 7.1% and excellent for 14.2% of patients. Patients who had pneumococcal and influenza vaccination had higher disease prevention HL scores (p = 0.013, p = 0.001; respectively). Discussion An insufficient HL level was found to be much higher than previous studies. It was observed that an increase in disease prevention HL was associated with a rise in the rate of pneumococcal and influenza vaccination.

The present study aims to biochemically analyze the fluid samples containing stone dust taken during the perioperative period to determine the role of fluid in the prediction of stones in patients treated with ureterorenoscopic procedures. Our secondary aim is to investigate the role of both fluid analysis and stone analysis in predicting the results of the metabolic analysis. Comparative analyses were performed using fluid samples containing stone dust from 93 patients. Biochemical analysis of fluid containing stone dust was conducted; stone fragments were examined at a separate location using X-ray diffractometry(XRD). Metabolic analysis was performed to patients who provided stone-free status 1 month later. The results of chemical analysis were compared with the results of the XRD analysis. Patients’ stone type was determined with high accuracy using biochemical analysis. Differences were noted in ten patients following biochemical analysis and XRD analysis. Biochemical analysis predicted metabolic disorders in more patients than XRD analysis, particularly for those patients with multiple stone compositions. However, no significant differences between the results of biochemical and XRD analysis methods were found (κ = 0.27; p = 0.002). Moreover, biochemical analysis results revealed metabolic disorders in five patients; these findings were missed by XRD analysis. Biochemical analysis of fluid taken perioperatively during ureterorenoscopic laser lithotripsy to treat urinary system stone disease was found to determine stone composition with high accuracy. Biochemical analysis of fluid samples taken during the perioperative period is, thus, an easy, reliable and cost-effective test to assess stone composition in patients undergoing ureterorenoscopic procedures.

Surgery is the first treatment option for patients with metopic craniosynostosis. Fronto-orbital advancement is the preferred method for correction of isolated trigonocephaly, but it is hard to understand whether surgery has been successful mainly in an early period. We aim to investigate the shape differences in the head shapes of trigonocephaly patients compared between preoperative and postoperative term. Cranial shape data were collected from the two-dimensional digital images. The Generalized Procrustes analysis was used to obtain mean shapes of the preoperative and postoperative term. The shape deformation of the frontal calvarium from preoperative to the postoperative term was evaluated using the thin-plate spline (TPS) method. There was significant cranial shape difference between preoperative and postoperative term. The high-level deformations for preoperative to postoperative term determined seen in TPS graphic. Highest deformation was observed at the bifrontal dimension especially at nasion and posterior edge of the forehead. In this study, we showed that the shape difference and structural deformation of the calvarium were correlated with the metopic craniosynostosis. The present study also shows that preoperative and postoperative head shapes of patients with trigonocephaly can be compared using the landmark-based geometrical morphometric method by taking into consideration the topographic distribution.

Obstructive sleep apnea syndrome (OSAS) is a commonly seen disorder characterized by repeated episodes of upper airway obstruction during sleep leading to intermittent hypoxemia or arousal. We aim to evaluate the effects of positive airway pressure (PAP) treatment on daytime sleepiness and serum Substance P (SP) levels in OSAS patients. Seventy-one consecutive patients with newly diagnosed OSAS and 19 non-apneic control subjects were enrolled to the study. PAP treatment indicated subjects were re-evaluated after 3 months of treatment. Morning SP levels of OSAS patients and Epworth sleepiness scale (ESS) were assessed at the beginning and then after 3 months of PAP treatment. Of the patients 71 (78.9%) were male and 19 (21.1%) were female, with a median age of 45 [20–62]. The levels of SP in the OSAS group were significantly lower than the snorer group and a significant correlation was not found between serum levels of SP and ESS. SP levels were negatively correlated with AHI. The baseline SP median was 336.1 pg/mL [121.6–536.1], while the 3rd month SP median was 213.1 pg/mL [103.5–727.6]. Serum SP values were found to have significantly decreased at 3 months (p

Objective: The present study, an international web-based survey, was focused on four aims: to obtain nursing professional’s self-reported statistical knowledge levels and how this knowledge varies by research area, to investigate and specify when biostatistics courses should be taught in nursing education and to identify the key statistical methods relevant to nursing education. Methods: A total of 448 nursing professionals from five continents and 52 countries participated in our study. For the data comparison, the Kruskal-Wallis test, the Mann-Whitney U test, the Pearson Chi Square and Fisher-Freeman-Halton tests were applied. Results: The results indicate that while nursing professionals place an emphasis on biostatistics education, the majority state that biostatistics education should be taken both at the undergraduate and postgraduate level and the participants also believe that taking a biostatistics course is useful for their occupation. A biostatistics education should also emphasize the necessity of consulting to a biostatistician when planning a study. Conclusion: Our study provides information regarding self-reported levels of biostatistical knowledge of nursing professionals by research area and academic position, and provides guidance regarding the ideal semester for administering a biostatistics course.

Numerous studies have found that the short-term results of laparoscopic sacrocolpopexy for pelvic organ prolapse are safe and effective. This study evaluates the long-term results of the laparoscopic sacrocolpopexy operation between the urology and gynecology branches. A prospective study enrolling 206 patients was conducted to evaluate laparoscopic sacrocolpopexy as a surgical treatment for vaginal vault prolapse from 2011 to 2014. Two different surgical branches (urology and gynecology) applied laparoscopic sacrocolpopexy to their patients with their own techniques. The long-term results were assessed postoperatively after 4 years by pelvic examinations, including the Pelvic Organ Prolapse Quantification system (POP-Q) and quality-of-life assessments using validated questionnaires. A total of 190 patients (94 urology and 96 gynecology patients) received a full clinical follow-up examination between April 2014–June 2018. Postoperative pelvic organ prolapse recurrence rates in each compartment were similar in both groups during the 4 years; 87.2% of the urology and 86.5% of the gynecology patients had no prolapse in any compartment according to the POP-Q system. The reoperation rate was 5.3% for the urology and 6.2% for the gynecology group. Mesh erosion was detected in two patients in both groups. Three patients responded to local estrogen therapy, and we removed the mesh vaginally in one patient. The subjective cure rate was 89.4% in the urology and 88.5% in the gynecology group after 4 years. Although different surgical branches perform laparoscopic sacrocolpopexy with their own techniques, long-term anatomical and functional results are similar between the branches. From a urogynecological point of view, laparoscopic sacrocolpopexy is a gold standard surgical procedure that can be performed by both urologists and gynecologists with similar long-term outcomes.

Aim: The aim of this study is to compare demographic characteristics, operative data, and complication rates of women who underwent total laparoscopic hysterectomy by the skeleton uterus technique (Skeleton-TLH) with those of women who underwent TLH by the standard technique (Standard-TLH) in a university teaching and research hospital. Materials and Methods: This retrospective study included 932 laparoscopic hysterectomies in a university teaching and research hospital between January 1, 2013 and December 31, 2017. Clinical characteristics, operative outcomes, and complications were recorded and compared for the two techniques. Results: In total, 932 laparoscopic hysterectomies were performed, 454 by Skeleton-TLH and 478 by Standard-TLH. The general demographic characteristics of the patients were similar; only gravida and parity were statistically significantly different between the groups (P < 0.001). Based on the primary outcomes (the operative data), total anesthesia time and main operation time were similar in the two groups. Estimated blood loss was statistically significantly lower in the Skeleton-TLH group than in the Standard-TLH group. Hospital stay was longer for the Skeleton-TLH group, and specimen weight was heavier. The secondary outcome was the complication rate. There were no differences between the Skeleton-TLH and Standard-TLH groups in the rates of all minor and major complications. Conclusion: TLH with the skeleton uterus technique is feasible and safe, especially for advanced pelvic surgeons. This technique not only provides retroperitoneal access to the pelvic spaces and good anatomical visibility; but it also delivers a safer laparoscopic hysterectomy by clamping the uterine arteries and monitoring the ureter throughout the operation.

Purpose: To show the reliabilities of the new mixture (composed of water, methylcellulose, lactulose, locust bean gum, and sorbitol) and to compare the luminal distension and radiological confidence scores of this solution with water-lactulose mixture. Material and methods: Computed tomography enterography (CTE) images in a three-year period were included randomly in our institutional review board-approved and retrospective study. Ninety-one patients drank a lactulose and water mixture (Group 1), and 54 patients drank the new mixture (Group 2). Patients who drank the oral contrast agent were taken to a 64-detector row multiple detector computed tomography machine. Coronal and sagittal reformatted images were also formed. The gastrointestinal tract was divided into 11 segments for scoring. Each segment was graded for distensional and radiological confidence. CTE images were evaluated by two radiologists. Results: Inter- and intra-reader reliabilities were good or excellent for all gastrointestinal segments in both groups (p < 0.001). The best κ values were obtained in sigmoid colon assessments. Lower agreement values were detected in duodenum and jejunum scores. The new mixture group (Group 2) showed better results than Group 1 for ileum and colonic segments according to distension and confidence scorings. Conclusions: Inter- and intra-reader reliabilities of the new mixture were good or excellent for CTE. The new mixture seems to be more efficient and reliable for ileum and colon. The new mixture can increase bowel distention, radiological confidence, and quality in CTE evaluations.

Aim When cerebellar tonsils are placed ≥ 5 mm below the foramen magnum, the situation is referred to as Chiari malformation Type I (CM-I). The prevalence of CM-I has been reported as 0.6%-1%. Due to obstruction in Cerebrospinal Fluid Circulation (CSF) circulation, formation of syrinx of the spinal cord can be observed in these patients. We aimed to ascertain whether the brain stem\'s shape differs in patients with syrinx and without syrinx, relative to healthy controls. Material and methods Data on marked brainstem regions were obtained from 2D digital image files. Generalized Procrustes analysis was used to evaluate shape differences among patients with syrinx, patients without syrinx, and healthy controls. Shape deformations among groups were examined by Thin Plate Spline (TPS) analysis. Results According to the brain stem shape, there were differences between patients with syrinx and controls and between patients without syrinx and controls. High-level deformations were also observed among the groups. Conclusion In the present study, the presence of shape deformations in Chiari patients\' brainstem was demonstrated. This is the first study using a landmark-based geometrical morphometric method to demonstrate the shape difference in Chiari patients\' brainstem.

Introduction: In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery bypass grafting (CABG). Methods: This single-center, retrospective study included a total of 40 patients with a previous CABG who were admitted to our emergency unit for any reason and underwent a contrast-enhanced chest computed tomography (patient group) and 40 patients without previous cardiac surgery (control group) between January 2018 and November 2019. The retrosternal area was compared between the groups using the statistical shape analysis method. The distance between the sternum and the ascending aorta and pulmonary artery was measured and anatomical deformations of the retrosternal area were examined. Results: There was a statistically significant difference in the anatomical structures of the retrosternal area between the patient and control groups (P0.05). Conclusions: Our study results showed narrowing of the retrosternal area following CABG and a shorter distance from the sternum to the pulmonary artery than the ascending aorta. Based on these findings, surgeons should be cautious about possible injuries in patients requiring cardiac surgery with repeated median sternotomy.

Background The novel coronavirus disease was declared as a pandemic and chronic kidney disease is an important risk factor for morbidity and mortality. Dialysis has additional contributions on transmission risk so prompt preventive strategies were implemented for dialysis patients. We aimed to evaluate pandemic‐related perceptions and concerns of dialysis patients and differences between dialysis modalities. Material‐Method An anonymous survey for assessing concerns, knowledge, and attitudes about the pandemic was sent online to a total of 339 patients on maintenance dialysis at 4 tertiary dialysis centers in Turkey. A total of 309 patients (54.9±15.1 years, 51.6% females, 55.7% in‐center hemodialysis, 44.3% peritoneal dialysis) enrolled. The anonymous online survey was conducted at the end of April 2020. Results HD patients were more concerned about transmission risk (P=0.002) and risks associated with the dialysis treatment environment and the transport methods (P

Background Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis. Methods In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared. Results The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealed Helicobacter pylori (HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%, p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity. Conclusions Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.

Introduction and hypothesis There has been a great deal of discussion about mesh complications in urogynecology in recent years. However, awareness of other doctors who are not urogynecologists is unknown. This study was aimed at determining the level of awareness of mesh discussions among medical doctors whose specialty is not urology or gynecology. Methods A survey study was administered, and all medical doctors, except gynecologists and urologists, were invited. Respondent doctors were classified into four groups: King's College Hospital (KCH), UK; Uludag University Hospital (UUH), Turkey; the United States (USA); and the world (WORLD). The primary outcome was the awareness of mesh discussion in urogynecology, and the secondary outcome was the social media awareness of the mesh discussion. Results 1231 doctors responded to the survey. The awareness of the current mesh problems among the respondent doctors was 15.8% in KCH, 15.4% in UUH, 26.9% in the USA, and 16.2% in WORLD. The social media awareness about mesh problems was 20.8% in KCH, 20.3% in UUH, 32.8% in the USA, and 20.6% in WORLD. Although there were no differences among three of the groups with regard to primary and secondary outcomes, the USA group score was statistically significantly higher than the others. Conclusions Social media can influence doctors' thinking on controversial academic issues. In this survey study, non-urogynecologist doctors in the USA cohort have higher awareness levels and a higher social media awareness level than other groups.

Objective: To investigate fatigue and sleep disorders based on demographic, clinical and polysomnographic data and show their effects on the quality of life in multiple sclerosis (MS) patients. Materials and Methods: Thirty MS patients were enrolled in the study depending on the results of the polysomnography (PSG), Fatigue Severity scale, Epworth Sleepiness scale (ESS), Pittsburgh Sleep Quality Iindex, Beck Depression and Anxiety inventories. Patients, using (n=16) and non-using (n=14) interferon, were compared with each other in all parameters; ESS and PSG data were compared with a control group consisting of 19 healthy people. Short form-36 (SF-36) data were also compared with the society norms. Results: Central fatigue was observed in 86.7% of the patients. PSG data revealed that stage N2 sleep duration of those who did not use interferon was significantly longer than those who used it (p

Encapsulating peritoneal sclerosis (EPS) is a serious complication for patients with chronic kidney disease (CKD) who were treated with long-term peritoneal dialysis (PD). The risk of EPS was increased after kidney transplantation. In our study we evaluated risk factors for EPS patients after kidney transplantation who were treated before with PD.In our study, between January 2008 and August 2015, 47 PD patients (12 had EPS) who underwent kidney transplantation were analyzed. Age, gender, time of PD treatment, human leukocyte antigen (HLA) matching, cold ischemia time, kidney function (serum urea, creatinine, etc), comorbidities, immunosuppressive therapy, clinical features, and outcomes of PD patients were retrospectively evaluated in both groups.Mean age was 42 (range, 25-60) years in EPS patients, versus 43 (range, 22-77) years without EPS (P = .798). Distribution of gender was similar in both groups (P = .154). The C-reactive protein levels (P .001), number of patients with peritonitis (P = .001), length of time on PD (P .001), and serum ferritin levels (P = .020) were higher in EPS patients. The immunosuppressive therapy was changed; tamoxifen and steroids were used after diagnosis in EPS patients. HLA matching was higher in the non-EPS group (P = .006). EPS was more often seen in patients who were treated with continuous ambulatory peritoneal dialysis (CAPD; 75%; P = .036). EPS was more often detected in cadaveric transplant recipients (83.3%; P = .024). High peritoneal transmittance rate was more identified in EPS (+) patients (P = .001). EPS was more often seen in patients who were treated with icodextrin-based regimens in PD before transplantation (91.7%; P = .037). The length of time on PD and high ferritin levels increased EPS 1.08 and 1.01, respectively (P = .036 and .049, respectively), in multivariate analysis.The length of time on PD, type of PD, PD regimens with icodextrin, episodes of peritonitis, and peritoneal transmittance in patients with CKD affect the development of EPS after transplantation.

Aim: The implementation of two different types of family medicine residency training program in Turkey, started a discussion among the academicians in our country. We planned this study to compare the opinions of domestic and foreign WONCA - Europe 2015 participants about the family medicine specialty education models based on Turkey example. Methods: Survey forms prepared in English and Turkish were submitted to the family physicians who agreed to participate in the study. Results: Participants reported two different views on the duality of family medicine residency training in Turkey. Participants from Turkey tended to have more negative opinions about the future and the sufficiency of part-time training and they demonstrated a more positive stance on the exam to select residency trainees and necessity of the scientific research and preparation of theses. Conclusions: Part-time training is a new practice for Turkey, but it has been experienced in many countries in the world for a long time. The opinions about the part-time expertise in our country seem to be negative, but it will be possible to evaluate the advantages and disadvantages of this system with the success of the doctors who will become residents with the system. Amac: Turkiye’de uygulanmakta olan iki farkli aile hekimligi uzmanlik egitim programi ulkemizdeki akademisyenler arasinda tartismaya yol acmistir. Bu calismayi, yerli ve yabanci WONCA katilimcilarinin, Turkiye’yi de ornek vererek aile hekimligi uzmanlik egitim modelleri konusundaki goruslerini karsilastirmak icin planladik. Yontem: Arastirmaya katilmayi kabul eden aile hekimlerine Ingilizce ve Turkce hazirlanmis anket formlari sunuldu. Bulgular: Kendilerine Turkiye’deki tam ve yari zamanli uzmanlik egitimi hakkinda kisa bir bilgi verilen katilimcilar, Turkiye'de aile hekimligi meslek egitiminde karsilasilan ikilem konusunda farkli gorusler bildirdiler. Yerli katilimcilar yari zamanli egitimin gelecegi ve yeterliligine iliskin daha olumsuz gorusler bildirirken, uzmanlik sinavi ve bilimsel arastirma ve tez hazirlama gerekliligi konusunda pozitif bir yaklasim sergilediler. Sonuclar: Dunyada “part-time (yari zamanli egitim)”, ulkemizde bu adla uygulamaya koyulan program ile ayni sekilde tanimlanmamis olmakla birlikte uzun suredir uygulanmaktadir. Ulkemiz icin ise daha yeni bir uygulamadir. Ulkemizde bu haliyle yari zamanli egitim ile ilgili olumsuz bir kanaat vardir fakat bu sistemin avantaj ve dezavantajlari bu yolla uzman olan hekimlerin mesleki yeterlilikleri olculerek degerlendirilebilir.

ResumoObjetivoIdentificaram‐se mutações no gene da febre mediterrânica (MEFV) relatadas como responsáveis pela febre mediterrânica familiar (FMF). Este estudo teve como objetivo determinar a frequência de mutações no MEFV na região sul do mar de Mármara e investigar o impacto dos polimorfismos genéticos G138G (rs224224, c.414A>G) e A165A (rs224223, c.495C>A) nos achados clínicos da doença.MétodosForam incluídos neste estudo 116 pacientes com diagnóstico de FMF e 95 indivíduos no grupo controle. Usou‐se o método de análise da sequência de DNA para identificar as 10 mutações mais prevalentes localizadas nos éxons 2 e 10 do gene MEFV.ResultadosComo resultado da análise da mutação MEFV, a mutação mais comum foi a mutação alélica M694V, com uma taxa de frequência de 41,8%. Quando os grupos de pacientes e controles foram comparados em termos de frequência de ambos os alelos polimórficos (alelo polimórfico G, observado no G138G e o alelo polimórfico A, observado no A165A), a variação observada foi estatisticamente significativa (p0,05).ConclusõesQue se tem conhecimento, este estudo é o primeiro feito na região sul do mar de Mármara que relata a frequência de mutações no MEFV. Os achados indicam que os polimorfismos G138G e A165A podem ter um impacto sobre o progresso da doença. Acredita‐se que são necessários mais estudos que abranjam um maior número de casos e investiguem os polimorfismos do gene MEFV.AbstractAimVarious mutations have been identified in the Mediterranean Fever (MEFV) gene which is reported to be responsible from Familial Mediterranean Fever (FMF). In our study, we aimed to determine the frequency of the MEFV mutations in our region and to investigate the impact of G138G (rs224224, c.414A>G) and A165A (rs224223, c.495C>A) gene polymorphisms on the clinical findings of the disease.MethodsOne hundred and sixteen patients diagnosed with FMF and 95 control subjects were included in this study. We used the DNA sequence analysis method to identify the most prevailing 10 mutations located in exon 2 and 10 of MEFV gene.ResultsAs a result of the MEFV mutation analysis, the most common mutation was the M694V mutation allele with a frequency rate of 41.8%. When the patients group and control group were compared in terms of frequency of both polymorphic alleles (G polymorphic allele, observed in G138G and the A polymorphic allele, observed in A165A), the variation was observed to be statistically significant (p0.05).ConclusionsTo our knowledge, our study is the first study in the Southern Marmara region that reports the frequency of MEFV mutations. Our findings imply that the polymorphisms of G138G and A165A may have an impact on progress of the disease. We think that more studies, having higher number of cases and investigating the polymorphisms of MEFV gene, are needed.

Aim: Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. Methods: A total of 81 patients (51 males, 30 females) with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results. Results: Most of the patients (55.6%) had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (21.2%) and rheumatoid arthritis (10.6%) in the good outcome group and malignancy (20%) in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in estimated glomerular filtration rate of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively). Median duration of renal survival was 65 +/- 3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow-up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios 1.03, 95% confidence interval: 1-1.06, p = 0.036], serum creatinine (hazard ratios 1.25, 95% confidence interval: 1.07-1.46, p = 0.006) and urinary protein excretion (hazard ratios 1.08, 95% confidence interval: 1.01-1.16, p = 0.027) were predictors of end-stage renal disease. Median survival of patients with organ involvement was 50.3 +/- 16 months. Conclusion: Our study indicated that familial Mediterranean fever constituted a large proportion of cases and increased number of patients with idiopathic amyloid A amyloidosis. Additionally, it was observed that patient survival was not affected by different etiological causes in amyloid A amyloidosis. Resumo Objetivo: A amiloidose AA é uma complicação rara de condições inflamatórias crônicas. A maior parte dos pacientes com amiloidose AA apresenta nefropatia, que leva à insuficiência renal e à morte. Estudaram-se as características clínicas e a sobrevida em pacientes com amiloidose AA. Métodos: Analisaram-se retrospectivamente 81 pacientes (51 homens, 30 mulheres) com amiloidose AA comprovada por biópsia renal. Os pacientes foram divididos em grupos de desfecho bom e ruim de acordo com os resultados de sobrevida. Resultados: A maior parte dos pacientes (55,6%) tinha proteinúria na faixa nefrótica no momento do diagnóstico. Os distúrbios subjacentes mais frequentes foram a febre familiar do Mediterrâneo (FFM, 21,2%) e a artrite reumatoide (10,6%) no grupo de desfecho bom e a malignidade (20%) no grupo de desfecho ruim. Somente a pressão arterial diastólica no grupo de desfecho bom e o nível de fósforo no grupo de desfecho ruim foram mais elevados. Os níveis séricos de creatinina aumentaram após o tratamento em ambos os grupos, enquanto a proteinúria diminuiu no grupo de desfecho bom. O aumento na creatinina sérica e a diminuição na TFGe do grupo de desfecho ruim foram mais significativos no grupo de desfecho bom. No momento do diagnóstico, 18,5% e 27,2% de todos os pacientes tinham doença renal crônica avançada (estágios 4 e 5, respectivamente). A duração média da sobrevida renal foi de 65 ± 3,54 meses. Entre todos os pacientes, 27,1% iniciaram tratamento de diálise durante o período de seguimento e 7,4% de todos os pacientes foram submetidos a transplante renal. Níveis elevados de pressão arterial sistólica [taxas de risco (HR) 1,03, intervalo de confiança (IC) de 95%: 1 a 1,06, p = 0,036], creatinina sérica (HR 1,25, IC 95%: 1,07 a 1,46, p = 0,006) e excreção urinária de proteínas (HR 1,08, IC 95%: 1,01 a 1,16, p = 0,027) foram preditores de doença renal terminal. A mediana da sobrevida de pacientes com comprometimento de órgãos foi de 50,3 ± 16 meses. Conclusão: O presente estudo indicou que a FFM constituiu uma grande proporção de casos e crescente quantidade de pacientes com amiloidose AA idiopática. Adicionalmente, observou-se que a sobrevida do paciente não foi afetada pelas diferentes causas etiológicas na amiloidose AA.

Aim Preterm premature rupture of membranes (PPROM) is not only the most common distinguishable cause of preterm delivery, but is also associated with adverse neonatal outcomes. We determined the platelet indices in PPROM cases and evaluated their relationship to adverse neonatal outcomes. Methods Fifty patients with PPROM and 50 patients who experienced spontaneous preterm labor at Results Patients with PPROM had increased mean platelet volumes (9.40 vs 10; P = 0.01), plateletcrit (0.19 vs 0.21; P = 0.03) and a higher frequency of neonatal sepsis (18% vs 38%; P = 0.02). Platelet indices in the patient group were compared according to the development of RDS. Plateletcrit values were higher in the RDS positive group (0.23 ± 0.05 vs. 0.21 ± 0.04; P = 0.04). The cut-off value for plateletcrit was determined as > 0.22, and the probability of RDS increased 5.86 times when plateletcrit values exceeded 0.22 (odds ratio 5.86, 95% confidence interval 1.01-32.01; P = 0.04). A one-unit increase in platelet distribution width resulted in a 1.33-fold increase in the risk of RDS (odds ratio 1.33, 95% confidence interval 1.01-1.77; P = 0.04). Conclusion Mean platelet volumes and plateletcrit significantly increased and plateletcrit had a predictive value for RDS in PPROM cases. Monitoring plateletcrit may be promising for predicting the development of RDS, one of the most common and serious complications of PPROM rupture.

WOS: 000409565700033, Horse flies (Diptera: Tabanidae) are known world-wide as important mechanical vectors of viruses, bacteria, protozoans, and helminths that cause diseases in wild and domestic animals. Tabanus bromius L. is common species worldwide, which shows considerable variation in the size of the body due to its adaptation to different habitats. In this paper, thirteen populations of this species, which are collected from different habitats and ecological regions (forests, sea sides and alpines) at altitudes between 5-2200 meters in Anatolia and Aegean were compared using geometric morphometries. When the wing shape differences of populations were analyzed by UPGM, the cluster analyses recognized two main groups of populations, one group comprising Afyon (890 m), Amasya (800 m), Artvin (960 m), Bolu (1200 m), Eskisehir (1170 m), Kastamonu (600 m) and Zonguldak (1050 m) while the second group comprised Bursa (700 m), Giresun (150 m), Sinop (160 m), Samsun (340 m), Karabiik (230 m) and Trabzon (200 m)., project of Anadolu University [BAP-1502F074], This research has been supported by project of Anadolu University numbered BAP-1502F074.

The purpose of this study was to investigate the relationship between the serum parathormone (PTH) levels measured after completion of hemithyroidectomy on the first side during total thyroidectomy and the postoperative hypocalcemia. The patients were divided into two groups, as those who demonstrated a decrease in PTH levels measured after completion of hemithyroidectomy of the first side (Group 1, n = 43) and those who did not demonstrate a decrease in PTH levels (Group 2, n = 24). The serum PTH levels were measured just before the incision (PTHi), when the hemithyroidectomy stage had been completed (PTHht), at the end of the operation (PTHtt), and at the postoperative 24th hour (PTH24hr). The serum total calcium (Ca21) levels were also measured. The median percentage differences in PTHtt levels based on basal PTHi levels of Groups 1 and 2 were -60.6 and -15.7 per cent, respectively, P = 0.001. The frequency of postoperative biochemical hypocalcemia was higher in Group 1, P < 0.05. It was determined that a 10 per cent or higher decrease in PTHht levels in Group 1 could predict biochemical hypocalcemia at the postoperative 24th hour. In conclusions, postoperative hypocalcemia is seen more frequent in patients with a decrease of PTHht during total thyroidectomy. A decrease of 10 per cent in PTHht levels measured after ipsilateral lobectomy and a 62 per cent or higher decrease in PTHtt levels measured in the end of the total thyroidectomy could be helpful for prediction of postoperative hypocalcemia in these patients.

Objective To compare the birth characteristics of Syrian refugees with those of Turkish citizens. Methods In a retrospective study, data were obtained for singleton live births that occurred at a hospital in Bursa, Turkey, between June 1 and December 31, 2015. All Syrian refugees were eligible for inclusion; one Turkish citizen was included for each refugee. Results Overall, 545 Syrian refugees and 545 Turkish citizens were included. Cesarean delivery was undertaken for 176 (32.3%) Syrians and 235 (43.1%) Turks (P

Study Objective To describe a new modification of laparoscopic sacrohysteropexy without using a mesh and report the 3-year outcomes. Design A prospective cohort study. Setting Minimally Invasive Gynecology Unit, Bursa Uludag University Hospital, Turkey. Patients Women who were diagnosed with ≥ stage 2 uterine prolapse. Interventions A laparoscopic sacrohysteropexy modification using a polyester fiber suture instead of a standard polypropylene mesh. Measurements and Main Results The primary outcome was the anatomic success of the repair, with success defined as objective parameters using the pelvic organ prolapse quantification system. The secondary outcomes were subjective outcomes, which were assessed using the quality-of-life scales. Forty-seven women who underwent the procedure were followed up for a minimum of 3 years. Forty-four of the 47 patients had stage 0 or 1 prolapse at the end of the second year, according to the primary outcomes. The anatomic success rate was 93.6%. In the secondary outcomes, 2 patients were not satisfied with their pelvic floor after the second year. The subjective cure rate was 95.7%. There was a statistically significant improvement in both pelvic organ prolapse quantification and quality-of-life scores in the third postoperative year. The mean operating time was 84.6 minutes, and the mean estimated blood loss was 21.3 mL. There were no bladder or bowel complications in the perioperative or postoperative period. Conclusion Laparoscopic sacrohysteropexy can be performed safely with this meshless modification in uterine prolapse as an alternative.

Objective: : To investigate the effect of challenging factors on laparoscopic hysterectomy trends within twenty-four years. Population and Method: : This was a trend analysis study of 7558 women who underwent hysterectomy for benign indications between 1995-2018 in Bursa Uludag University Hospital, Turkey. A trend analysis of obesity, previous laparotomy (>= 3) and uterine specimen weight (>= 500 g) was applied for abdominal hysterectomy (TAH), vaginal hysterectomy (VH), and laparoscopic hysterectomy (TLH) rates in this period. The primary outcome was laparoscopic hysterectomy trends throughout the years. We measured the effect of obesity, previous laparotomies and large uterus on TLH trends as secondary outcomes. Results: : The ratio of TLHs to all hysterectomies was 2.4% in 1995 and 44.7% in 2018 which increased 33 times higher over 24 years. The percentage of obese patients in TLH cases increased from 1% to 37%, the rate of patients who had three or more previous laparotomy in TLH cases increased from 0% to 32.2%, and the percentage of patients who had more than 500 g uterus specimen in laparoscopic hysterectomy cases increased from 0% to 32.8%. Conclusion: : Laparoscopic hysterectomy trends are increasing in challenging cases. Obesity, previous surgeries, and large uteruses are no longer a limiting factor for laparoscopic hysterectomy. (C) 2019 Elsevier Masson SAS. All rights reserved.

Aim To investigate the differences in the head shapes of scaphocephaly patients during the pre- and postoperative phases. Material and methods Cranium shape data were collected from the two-dimensional digital images. The generalised Procrustes analysis was used to obtain mean shapes in the pre- and postoperative phases. The shape deformation of the cranium from the pre- to postoperative phases was evaluated using the thin plate spline method. Results There was no significant cranial shape difference in the pre and postoperative phases. The high-level deformations from the pre- to postoperative phase were seen in thin plate spline graphs. The highest deformation was observed at the biparietal dimension. Conclusion In this study, we showed that the structural deformation of the cranium was correlated with sagittal craniosynostosis. The present study also shows that pre- and postoperative head shapes of patients with scaphocephaly can be compared using head shape with the landmark-based geometric morphometric method by taking into consideration the topographic distribution.

Purpose: To determine the effect of parathyroid autotransplantation (PA) on postoperative hypocalcemia in cases of total thyroidectomy. Materials and Methods: Cases undergoing total thyroidectomy and PA were compared with age and sex-matched controls who had not undergone PA. The postoperative percentage changes (PC) of parathyroid hormone (PTH) and calcium (Ca+2) in the first 12-24 hours (12-24 -> hrpreop), between the 1st-3rd weeks (1-3 -> wkpreop) and at the 6th month (6mo -> preop), the rates of hypocalcemia (Ca+2< 8mg/dL) and low PTH level (PTH< 15 pg/mL), permanent hypocalcemia, inadvertent parathyroidectomy in both groups were compared. Results: The number of patients with PTH12-24hr preop) was significantly higher in the PA group (4.2%) than the control group (1.1%), (p=0.008). There was no significant difference between the 2 groups in terms of the postoperative frequency of hypocalcemia (p>0.05). In the PA & 50 group, the rate of inadvertent parathyroidectomy was higher than that of cases over age 50 (p=0.029). Conclusion: In spite of the presence of an increased postoperative hypocalcemia trend in cases requiring PA during total thyroidectomy, the rates of transient and permanent hypocalcemia were not different to the control cases. But the frequency of cases with low PTH level in cases undergoing PA was higher than that of the control cases. In cases of 50 years of age and under, who had undergone PA, the possibility of inadvertent parathyroidectomy increased.

Background/PurposeGlomerulonephritis is among the most important group of diseases causing end-stage renal disease (ESRD). The prevalence of glomerulonephritis varies depending on age, sex, geographical features, etc. In the present study, we evaluated the clinical and laboratory parameters of patients who underwent renal biopsy.MethodsIn this retrospective study, demographic and clinical characteristics, specific diagnoses of glomerular diseases, and biopsy findings of all patients in whom native renal biopsy was performed in our hospital between January 2009 and December 2014 were analyzed.ResultsA total of 384 patients were divided into two groups as primary glomerular diseases (PGD) and secondary glomerular diseases (SGD). Some 37.1% of patients with PGD and 49.2% of patients with SGD were female. The mean age was 43.8 ± 14.1 years in the PGD group and 47.3 ± 16.1 years in the SGD group (p = 0.044). Nephrotic syndrome in the PGD group and unexplained renal dysfunction in the SGD group were observed more frequently at the time of admission. In the SGD group, biopsy findings (crescents, sclerosis, vascular involvement, etc.) were dominant and more pronounced (p