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Glioblastoma is one of the most devastating neoplasms of the central nervous system. This study focused on the development of serum extracellular vesicle (EV)-based glioblastoma tumor marker panels that can be used in a clinic to diagnose glioblastomas and to monitor tumor burden, progression, and regression in response to treatment. RNA sequencing studies were performed using RNA isolated from serum EVs from both patients (n = 85) and control donors (n = 31). RNA sequencing results for preoperative glioblastoma EVs compared to control EVs revealed 569 differentially expressed genes (DEGs, 2XFC, FDR < 0.05). By using these DEGs, we developed serum-EV-based biomarker panels for the following glioblastomas: wild-type IDH1 (96% sensitivity/80% specificity), MGMT promoter methylation (91% sensitivity/73% specificity), p53 gene mutation (100% sensitivity/89% specificity), and TERT promoter mutation (89% sensitivity/100% specificity). This is the first study showing that serum-EV-based biomarker panels can be used to diagnose glioblastomas with a high sensitivity and specificity.

Background In small children, acute dialysis (pediatric acute kidney support therapy (paKST)) is increasingly used; however, it is challenging for many reasons. We compared clinical characteristics and predictors of long-term outcomes of patients < 15 kg on peritoneal dialysis (PD), hemodialysis (HD), and continuous kidney replacement therapy (CKRT). Methods Patients with history of paKST (CKRT, HD, PD) weighing < 15 kg and [greater than or equal to] 6 months of follow-up at Hacettepe University were included. Surviving patients were evaluated at last visit. Results 109 patients (57 females) were included. Median age at paKST was 10.1 months (IQR: 2-27 months). In total, 43 (39.4%) patients received HD, 37 (34%) PD, and 29 (26.6%) CKRT. 64 (58.7%) patients died a median 3 days (IQR: 2-9.5 days) after paKST. Percentages of patients using vasopressor agents, with sepsis, and undergoing mechanical ventilation were lower in those who survived. After mean follow-up of 2.9 ± 2.1 years, 34 patients were evaluated at mean age 4.7 ± 2.4 years. Median spot urine protein/creatinine was 0.19 (IQR: 0.13-0.37) and 12 patients (35.3%) had non-nephrotic proteinuria. Three patients had estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m.sup.2 and 2 (6%) had hyperfiltration. In total 22 patients (64.7%) had [greater than or equal to] 1 kidney risk factor (elevated blood pressure/hypertension, hyperfiltration, eGFR < 90 ml/min/1.73m.sup.2, and/or proteinuria) at last visit. Among 28 patients on paKST < 32 months, 21 had [greater than or equal to] 1 risk factor (75%), whereas among 6 patients who had paKST [greater than or equal to] 32 months, one patient had [greater than or equal to] 1 risk factor (16.7%), (p = 0.014). Conclusions Patients on paKST who undergo mechanical ventilation and vasopressor treatment should be followed-up more closely. After surviving the acute period, patients on paKST need to be followed-up closely during the chronic stage. Graphical abstract, Author(s): Ömer Nazim Gülçek [sup.1] , Bora Gülhan [sup.2] , Selman Kesici [sup.3] , Eda Didem Kurt Sükür [sup.2] , Mutlu Hayran [sup.4] , Fatih Ozaltin [sup.2] [sup.5] [sup.6] , [...]

Objective: Home program (HP) compliance is a crucial matter for parents of cerebral palsy (CP). A questionnaire is needed to determine the compliance and perceptions of parents of children with CP regarding the HP. The aim is to evaluate the structural validity, reliability, and responsiveness of Compliance and Perceptions of Parents of Children with Cerebral Palsy to Home Program Assessment Questionnaire (CPHP-Q). Methods: Parents of children with CP aged 2-18 years completed CPHP-Q (n=225). Among all participants, 70 individuals were randomly selected for responsiveness, and another 70 individuals were selected for reliability. Psychometric properties were evaluated using the intraclass correlation coefficient (ICC) and Cronbach's Alpha for reliability, effect size (ES) and standard response mean (SRM) for responsiveness, and factor analysis for validity. Results: In parents with CP, CPHP-Q demonstrated high internal consistency (Cronbach's alpha=0.96, ICC=0.93). Compliance and Perceptions of Parents of Children with Cerebral Palsy to Home Program Assessment Questionnaire showed significant responsiveness with ES value 1.31 and SRM value 1.29. Kaiser Meyer Olkin (KMO) was found to be significant with a value of 0.82. According to factor analysis, Chi-square/degrees of freedom (CMIN/DF)=2.25, The Root Mean Square Error of Approximation (RMSEA)=0.07, Goodness of Fit Index (GFI)=0.84, and comparative fit index (CFI)=0.93 were found. These values showed that model fit was good. Conclusion: The CPHP-Q is a valid, reliable, and responsive measure for HP adherence of parents of children with CP, and it is useful for determining HP implementation adherence and perceptions of parents but needs validation in other languages. [ABSTRACT FROM AUTHOR]

Background Atypical hemolytic uremic syndrome (aHUS) is a chronic disease characterized by thrombotic microangiopathy and a high risk of end-stage kidney disease. Dysregulation and/or excessive activation of the complement system results in thrombotic microangiopathy. Interest in extrarenal manifestations of aHUS is increasing. This study aimed to determine the clinical characteristics of patients with extrarenal manifestations of aHUS in childhood. Methods This study included 70 children with extrarenal manifestations of HUS from the national Turkish aHUS Registry. The demographics, clinical characteristics, genetic test results, all treatments, and renal/hematologic status of aHUS patients with extrarenal involvement were recorded. Results The most common extrarenal manifestation was neurological system involvement (n = 46 [27.2%]), followed by gastrointestinal (n = 20 [11.8%]), cardiovascular (n = 12 [7%]), and respiratory (n = 12 [7%]) involvement. The patients with neurological involvement had a higher mortality rate and a lower estimated glomerular filtration rate (eGFR) than the other patients at last follow-up. Eculizumab (with or without plasma exchange/plasma infusion) treatment increased the renal and hematologic recovery rates. Conclusions The most common and serious extrarenal manifestation of aHUS is neurological involvement and treatment outcome findings presented herein are important to all relevant clinicians., Author(s): Kibriya Fidan [sup.1] , Nilüfer Göknar [sup.2] , Bora Gülhan [sup.3] , Engin Melek [sup.4] , Zeynep Y. Yildirim [sup.5] , Esra Baskin [sup.6] , Mutlu Hayran [sup.3] , [...]

Objective To investigate public compliance with legislation to prohibit smoking within public buildings and the extent of tobacco smoking in outdoor areas in Turkey. Methods Using a standardized observation protocol, we determined whether smoking occurred and whether ashtrays, cigarette butts and/ or no-smoking signs were present in a random selection of 884 public venues in 12 cities in Turkey. We visited indoor and outdoor locations in bars/nightclubs, cafes, government buildings, hospitals, restaurants, schools, shopping malls, traditional coffee houses and universities. We used logistic regression models to determine the association between the presence of ashtrays or the absence of no- smoking signs and the presence of individuals smoking or cigarette butts. Findings Most venues had no-smoking signs (629/884). We observed at least one person smoking In 145 venues, most frequently observed in bars/nightclubs (63/79), hospital dining areas (18/79), traditional coffeehouses (27/120) and government-building dining areas (5/23). For 538 venues, we observed outdoor smoking close to public buildings. The presence of ashtrays was positively associated with indoor smoking and cigarette butts, adjusted odds ratio, aOR: 315.9; 95% confidence interval, CI: 174.9-570,8 and aOR: 165.4; 95% CI: 98.0-279.1, respectively. No-smoking signs were negatively associated with the presence of cigarette butts, aOR: 0.5; 95% CI: 0.3- 0.8. Conclusion Additional efforts are needed to improve the implementation of legislation prohibiting smoking in indoor public areas in Turkey, especially in areas In which we frequently observed people smoking. Possible interventions include removing all ashtrays from public places and increasing the number of no-smoking signs. Objectif Analyser le respect de la legislation interdisant de fumer a l'interieur des batiments publics ainsi que l'ampleur du tabagisme en exterieur en Turquie. Methodes Suivant un protocole d'observation standardise, nous avons determine si des personnes avaient fume et si des cendriers, des megots de cigarettes et/ou des panneaux Interdisant de fumer etaient presents dans 884 lieux publics selectionnes au hasard dans 12 villes turques. Nous nous sommes rendus dans des bars/discotheques, cafes, batiments gouvernementaux, hopitaux, restaurants, etablissements scolaires, centres commerciaux, cafes traditionnels et universites oU nous avons examine les espaces interieurs et exterieurs. Nous avons utilise des modeles de regression logistique pour determiner l'association entre la presence de cendriers ou l'absencede panneaux Interdisant de fumer et la presence de personnes en train de fumer ou de megots de cigarettes. Resultats La plupart des lieux disposaient de panneaux interdisant de fumer (629/884). Nous avons observe au moins une personne en train de fumer dans 145 lieux, le plus souvent dans les bars/discotheques (63/79), les espaces-repas des hopitaux (18/79), les cafes traditionnels (27/120) et les espaces-repas des batiments gouvernementaux (5/23). Dans 538 lieux, nous avons observe que des personnes fumaient a l'exterieur pres de batiments publics. La presence de cendriers etait positivement associee au fait de fumer a l'interieur et a des megots de cigarettes, rapport des cotes ajuste (RCa): 315,9; intervalle de confiance (IC) de 95%: 174,9-570,8 et RCa: 165,4; IC 95%: 98,0-279,1, respectivement. Les panneaux interdisant de fumer etaient negativement associes a la presence de megots de cigarettes, RCa: 0,5; IC 95%: 0,3-0,8. Conclusion Des efforts supplementaires doivent etre deployes afin d'ameliorer l'application de la legislation Interdisant de fumer a l'interieur des lieux publics en Turquie, en particulier dans les lieux oU nous avons frequemment observe des personnes qui fumaient. Les actions possibles pourraient consister a retirer tous les cendriers des lieux publics et a augmenter le nombre de panneaux interdisant de fumer. Objetivo Investigar el cumplimiento publico de la legislacion que prohibe fumar en edificios publicos y el grado de consumo de tabaco en las zonas exteriores en Turquia. Metodos Mediante un protocolo de observacion estandarizado, se determino si se fumaba y si habia ceniceros, colillas o senales de prohibido fumar en una seleccion aleatoria de 884 espacios publicos de 12 ciudades turcas. Se visitaron tanto espacios interiores como exteriores en bares/discotecas, cafeterias, edificios gubernamentales, hospitales, restaurantes, escuelas, centros comerciales, cafeterias tradicionales y universidades. Se utilizaron modelos de regresion logistica para determinar la asociacion entre la presencia de ceniceros o la ausencia de senales de prohibido fumar y la presencia de colillas o personas fumando. Resultados La mayoria de espacios contaban con senales de prohibido fumar (629/884). Se observo al menos una persona fumando en 145 espacios, algo que se observo con mas frecuencia en bares/discotecas (63/79), comedores de hospitales (18/79), cafeterias tradicionales (27/120) y comedores de edificios gubernamentales (5/23). En 538 espacios, se observo gente fumando en el exterior cerca de edificios publicos. La presencia de ceniceros se relaciono de forma positiva con el hecho de fumar en interiores y la presencia de colillas, cociente de posibilidades ajustado, CPa: 315,9; Intervalo de confianza, IC, del 95%: 174,9-570,8 y CPa: 165,4; IC del 95%: 98,0-279,1, respectivamente. Las senales de prohibido fumar se relacionaron de forma negativa con la presencia de colillas, CPa: 0,5; IC del 95%: 0,3-0,8. Conclusion Se necesitan esfuerzos adicionales para mejorar la aplicacion de la legislacion que prohibe fumar en areas publicas Interiores en Turquia, especialmente en areas en las que se han observado fumadores frecuentemente. Las posibles Intervenciones incluyen eliminar todos los ceniceros de los lugares publicos y aumentar el numero de senales de prohibido fumar., Introduction To protect everyone from the detrimental effects of exposure to second-hand tobacco smoke, (1,2) the World Health Organization's Framework Convention on Tobacco Control has called for comprehensive legislation to [...]

Aim: Cancers are Turkey's second most common cause of mortality, following cardiovascular diseases. Tobacco and obesity are the two major etiological factors for cancer progression, which are highly prevalent in Turkey. This study aimed to evaluate the new cancer cases in Turkey attributable to these two main risk factors. Materials and Methods: The tobacco-related cancers based on the International Agency for Research on Cancer (IARC) monographs were esophagus, oral cavity, gastric, pancreatic, larynx, lung, renal, and bladder cancers, and the obesity-related cancers based on the IARC's and World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Continuous Update Project's reports were esophagus, colon, rectum, gallbladder, pancreas, kidney, ovary, endometrium, and breast cancers. The cancer incidences were obtained from the national cancer statistics. A lag time of at least 10 years was considered adequate to observe past exposures' effects on new cancer cases. The prevalence of tobacco smoking was based on the Peto-Lopez approach. The obesity prevalence was obtained from the National Burden of Disease and Cost-Effectiveness Project Household Survey, 2003 Report in Turkey. Using these incidence and prevalence data, we estimated the population-attributable fractions (PAF) of cancers attributable to smoking and obesity in Turkey. Results: For tobacco-related cancers, the highest PAFs were found in lung cancer (89.8%), larynx cancer (86%), oral cavity and pharynx cancer (77.2%) in males, and larynx cancer (46.5%), lung cancer (43%), and esophagus cancer (31.4%) in females. For obesityrelated cancers, the highest PAFs were found in esophagus adenocarcinoma (31.4%), kidney cancer (19.8%), gallbladder cancer (15.1%) in males, and esophagus adenocarcinoma (33.9%), endometrium cancer (32.8%), and postmenopausal breast cancer (22.8%) in females. When all tobacco-related cancers were considered, 41,283 cases in males and 3,853 cases in females were attributable to tobacco smoking, and when all obesity-related cancer types were considered, the number of attributable cancer cases to obesity was 2,653 in men and 7,387 in women. Conclusion: The current avoidable cancer burden in Turkey shows that eliminating tobacco smoking and obesity may prevent more than 50,000 cancer cases in Turkey. [ABSTRACT FROM AUTHOR]