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Background/Objectives : Inflammatory bowel diseases primarily encompass Crohn's disease and ulcerative colitis. Insufficient levels of tryptophan cause an imbalance in the gut microbiota, leading to inflammation in the gastrointestinal tract. The main catabolic pathway of tryptophan is the kynurenine pathway. Our study aims to evaluate serum tryptophan, the kynurenine pathway, and oxidative stress parameters, including total oxidant status and total antioxidant capacity, in patients with Crohn's disease and ulcerative colitis. Methods : The study included 80 follow-up patients in remission diagnosed with Crohn's disease and ulcerative colitis who attended the Gastroenterology Outpatient Clinic, as well as 78 healthy controls. Serum tryptophan, kynurenine, 3-hydroxykynurenine, 3-hydroxyanthranilic acid, and kynurenic acid levels were measured with liquid chromatography and tandem mass spectrometry (LC-MS/MS). All statistical analysis was performed using R version 4.2.1. Statistical Language. Results : Serum tryptophan, 3-hydroxyanthranilic acid, and total antioxidant capacity were lower in patients with ulcerative colitis and Crohn's disease compared to those in the control group. The serum total oxidant status in the control group was significantly lower than in patients with Crohn's disease and ulcerative colitis. Conclusions : The results of our research indicate that tryptophan and kynurenine pathway metabolites could potentially contribute to the pathogenesis of inflammatory bowel diseases.

Behçet's disease (BD) is a systemic disease with unknown etiopathogenesis and varying disease presentations. Fatty acids (FA) are essential biological compounds that are involved in complex metabolic pathways. They may contribute to inflammation and endothelial dysfunction by participating in many signaling pathways. Increased FAs levels are associated with an increased risk for various diseases. This study aimed to determine the relationship between FA, BD, and thrombotic complications. A total of 97 patients were recruited from the rheumatology department of a single center as a case-control study. The participants were divided into three groups: 36 patients with BD with thrombosis (Group 1), 24 patients with BD without thrombosis (Group 2), and 37 age- and sex-matched controls (Group 3). The analysis of 37 different FA with carbon numbers in the range of (4:0) and (24:1) in the samples were analyzed and compared between groups. Myristic acid (MA), methyl eicosatrienoate, and stearic acid (STA) levels were found to be significantly higher in BD with thrombosis than in BD without thrombosis, and palmitic acid (PA) levels were significantly higher in BD with thrombosis than in healthy individuals. MA was found to be a significant marker for differentiating between thrombotic BD. PA and STA are important markers for detecting thrombotic BD. In BD, lipotoxicity created by FA, such as PA, STA, and MA, plays a role as an inducer of inflammation and thrombosis through various mechanisms., (© 2024 AOCS.)

Background: It is well-known that oral surgical procedures pose a high risk for medication-related osteonecrosis of the jaw in patients taking bisphosphonates. Although some position papers and guidelines have been published with regard to its treatment, few studies have investigated prevention methods. This study investigates the effectiveness of methenolone enanthate, an anabolic steroid, for the prevention of medication-related osteonecrosis of the jaw., Methods: Thirty-six Wistar rats were divided into three groups. Two experimental groups, Z and ZM, took zoledronic acid for 6 weeks prior to extraction of the left maxillary first molar. The Group ZM also was given methenolone enanthate continuously for 1 week before and 4 weeks after the extraction. The control group was not given any medication. The rats were euthanized 5 weeks after extraction. The extraction socket was evaluated clinically for bone exposure and histologically for inflammation, hyperemia, collagen fibers, epithelialization, number of osteoclasts, and empty lacunae., Results: Six rats died during the experimental research. The bone exposure rate, mean numbers of attached osteoclasts (in 40× magnification), and empty lacunae (in 100× magnification) were 0%, 4%, and 0.8% in Group C; 75%, 1%, and 8% in Group Z; and 10%, 2.1%, and 3% in Group ZM, respectively. Significant differences exist between all groups regarding the number of empty lacunae. There were significant differences between Group C/ZM and Group Z in terms of bone exposure rate, inflammation, hyperemia, collagen fiber organization, and epithelialization., Conclusion: In our tested preclinical model, methenolone enanthate has shown potential for preventing medication-related osteonecrosis of the jaw., (© 2024 The Author(s). Journal of Oral Pathology & Medicine published by John Wiley & Sons Ltd.)

Objective: The aim of our study was to investigate the relationship between missed abortion and serum trimethylamine N-oxide (TMAO) levels., Methods: A total of 129 patients with 56 missed abortions and 73 healthy pregnancies were included in our study. Patients who had more than one pregnancy loss, had systemic disease (hypertension, diabetes, rheumatologic disease, hematologic disease, and so forth) and did not accept to participate in the study were excluded. Pregnant women who did not have a fetal heartbeat in the first 20th week of pregnancy were considered as missed abortion. Demographic characteristics of the patients were recorded. The serum TMAO levels of these patients were compared with the serum TMAO levels of healthy pregnant women with the same gestational week between the two groups., Results: The median (IQR) serum level of TMAO was significantly higher in woman with missed abortus compared to the healthy controls (201.5 [IQR, 129.75-345] vs 150 [IQR, 86.9-273], U = 1534, P = 0.015, r rb  = 0.25 [95% CI: 0.05-0.43]). We observed a positive and significant relationship between serum TMAO levels and age of the patients (Spearman's rho = 0.272 [95% CI: 0.01-0.50], P = 0.043). However, no significant relationship was found between serum TMAO levels and BMI (Spearman's rho = 0.093 [95% CI: -0.18 to 0.35], P = 0.496)., Conclusion: In our study, we found that the serum TMAO level was higher in patients with missed abortion compared to healthy pregnancies. Serum TMAO levels measured at early gestational weeks can provide information about the course of pregnancy., (© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)

Background: Dental anxiety is a common problem for oral surgeries. This study investigated the effectiveness of wearing glasses with green lenses in reducing dental anxiety, blood pressure, heart rate, and intraoperative pain in patients undergoing first-time third-molar surgery., Methods: The authors planned this study as a randomized and parallel-group clinical trial. Patients' dental anxiety was measured with the use of a visual analog scale and a State-Trait Anxiety Inventory for baseline measurement purposes. At the same time, blood pressure, oxygen saturation, and heart rate values were recorded. Patients were given glasses with clear or green lenses, depending on their group. After 10 minutes, all parameters were measured again for preoperative measurement. Patients wore glasses with either green or clear lenses throughout the operation. After the operation, patients were asked to estimate the degree of intraoperative pain using the visual analog scale., Results: The study included 128 patients. On the basis of the change between baseline and preoperative measurements, the authors found a statistically significant difference in anxiety and heart rate. Intraoperative pain showed a significant difference between groups. No significant changes were found in blood pressure and oxygen saturation., Conclusions: Patients with anxiety could wear low-cost, easy-to-use glasses with green lenses for 10 minutes before an operation to reduce anxiety and heart rate. In addition, wearing glasses during the surgical procedure can reduce intraoperative pain., Practical Implications: By means of using glasses with green lenses throughout the procedure, existing anxiety and pain can be reduced. An operation can be performed more comfortably for both the patient and the dentist. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT05584696., Competing Interests: Disclosures None of the authors reported any disclosures., (Copyright © 2024 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Background: Given the critical importance of Low-density lipoprotein cholesterol (LDL-C) levels in determining cardiovascular risk, it is essential to measure LDL-C accurately. Since the Friedewald formula generates incorrect predictions in many circumstances, new equations have been developed to overcome the Friedewald equations' shortcomings. This study aimed to compare estimated LDL-C with directly measured LDL-C (dLDL-C), as well as their performance in predicting LDL-C, utilizing Friedewald, extended Martin-Hopkins, Sampson, de Cordova, and Vujovic formulas and five machine learning (ML) algorithms., Methods: A total of 29,504 samples from the ISLAB-2 Core Laboratory were included in the study. All statistical analysis was performed using R version 4.1.2. Statistical Language., Results: Bayesian-Regularized Neural Network (BRNN) (r = 0.957) and Random Forest (RF) (r = 0.957) algorithms showed a higher correlation with dLDL-C than the other equations in all-testing dataset. All ML algorithms demonstrated less bias than pre-existing LDL-C equations with dLDL-C and outperformed the LDL-C estimation equations in terms of concordance in all-testing dataset., Conclusions: The results of our research indicate that when compared to conventional equations, ML algorithms are much more effective in predicting LDL-C. ML algorithms, aided by a vast dataset, could have the capability to predict LDL-C levels even in cases where triglyceride levels are high, unlike the limited usage of Friedewald formula., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Cribriform comedo-type adenocarcinoma (CCA) was a colon cancer subtype defined in the 2009 World Health Organization (WHO) classification. In the 2018 classification, it was a colon cancer subtype included in the adenocarcinoma, Not otherwise specified (NOS) group. A few studies have reported that colon cancers with a cribriform pattern have worse overall survival, and most of them are microsatellite stable (MSS). In this study, we evaluated CCAs based on their clinicopathologic features and microsatellite stability. We aimed to answer whether these tumors could be defined as a distinct morphologic subtype with prognostic significance., Materials and Methods: Pathology reports and specimens from 449 patients with colorectal adenocarcinoma (CRA) were re-evaluated. All subtypes were determined. To evaluate MSS status, the CCA cases were immunohistochemically stained with anti-MLH1, MSH2, MSH6, and PMS2 antibodies., Results: CCA was present in 40.5% of cases. These cases were found to have higher rates of lymph node metastasis, lymphovascular-perineural invasion, metastasis, and advanced stage ( P < 0.05). Also, 2.7% of CCA cases were microsatellite instable (MSI). However, no statistically significant result was found regarding overall survival and progression-free survival of CCA cases with MSI., Conclusion: According to the findings, CRAs with comedo cribriform patterns are tumors with more aggressive features. It can be said that these tumors have a specific molecular feature related to MSS. Because this feature is important for planning adjuvant chemotherapy, it may be useful to identify cases, particularly with a cribriform comedo pattern >90%. However, because no significant difference in survival rates was found, CCAs may not need to be defined as distinct subtypes., (Copyright © 2023 Copyright: © 2023 Indian Journal of Pathology and Microbiology.)

Objective: In this study, we aimed to investigate the effectiveness of the use of polypropylene mesh and platelet-rich fibrin (PRF) in nasal septal perforation (NSP) repair., Study Design: Prospective experimental study., Setting: Laboratory., Methods: Twenty-four adult male New Zealand rabbits were used in our study. In all subjects, a 10 × 10 mm perforation was created in the septum. The subjects were divided into 3 equal groups according to the different methods used in perforation closure. The bilateral mucosal flap was used in the control group, polypropylene mesh + bilateral mucosal flap in the mesh group, and polypropylene mesh + bilateral mucosal flap + PRF in the mesh + PRF group., Results: NSP treatment success rate was found to be significantly higher in the mesh (4/6, 66.7%) and mesh + PRF (6/6, 100%) groups compared to the control group (0/6, 0%). Re-epithelialization score was higher in the mesh + PRF group and the control group compared to the mesh group. While the necrosis, neutrophil, and abscess scores were highest in the mesh group, they were similar to the control group in the mesh + PRF group., Conclusions: While polypropylene mesh significantly increases the success rate in NSP repair, it causes severe inflammatory responses. However, when polypropylene mesh is combined with PRF, it both increases the rate of perforation closure and significantly reduces the complications associated with the use of mesh., (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

Objective: We aimed to evaluate the enzyme activity of chitotriosidase as a biomarker in early diagnosis silicosis and to investigate immune system response and oxidative stress caused by silica exposure., Materials and Methods: Silicosis patients (n = 116), exposed to silica without disease (n = 76), and healthy individuals (n = 55) were included. Serum levels of chitotriosidase, proinflammatory cytokines, oxidant-antioxidant, and immune parameters were measured., Results: Serum chitotriosidase enzyme levels in the silicosis group were statistically significantly higher than the exposure and control groups. Inflammatory biomarkers and 8-hydroxy-2-deoxyguanosine levels were found to be statistically significantly higher in the silicosis and exposure group compared with the controls, while superoxide dismutase and glutathione peroxidase were lower., Conclusions: Increased serum chitotriosidase level emerged as a biomarker that can not only distinguish silicosis from exposure and healthy controls but also indicate early pulmonary effects of silica., Competing Interests: Conflict of interest: None declared., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Purpose: This study evaluates the prognostic role of different [ 18 F]FDG PET/CT metabolic response criteria in metastatic breast cancer (MBC) patients treated with cyclin-dependent kinase 4/6 inhibitors (CDK 4/6)., Materials and Methods: We retrospectively evaluated the data of MBC patients treated with CDK 4/6 inhibitors who underwent an [ 18 F]FDG PET/CT scan before starting and during treatment. [ 18 F]FDG PET/CT response was assessed with the European Organization for Research and Treatment of Cancer (EORTC), PET Response Criteria in Solid Tumors (PERCIST), and whole-body total lesion glycolysis (WBTLG) criteria. Fleiss kappa was computed to assess the agreement between metabolic response criteria. The endpoint of the study was progression-free survival (PFS). PFS data were analyzed by the Kaplan-Meier method and compared using the log-rank test., Results: The study included sixteen MBC patients who received CDK 4/6 inhibitors therapy. According to PERCIST, partial metabolic response (PMR) was found in seven patients, stable metabolic disease (SMD) in seven patients, and progressive metabolic disease (PMD) in two patients. According to EORTC, PMR was detected in eight patients, SMD in seven patients, and PMD in one patient. According to WBTLG, PMR was found in 10 patients, SMD in four patients, and PMD in two patients. There was a fair agreement between the three criteria. While progression was detected in seven of the patients during follow-up, no progression was detected in nine of them. Kaplan-Meier analysis revealed that the responders according to WBTLG showed significantly longer PFS than non-responders., Conclusion: Treatment response according to WBTLG criteria during treatment appears to be associated with prolonged PFS in patients treated with CDK 4/6 inhibitors for MBC., (Copyright © 2023 Sociedad Española de Medicina Nuclear e Imagen Molecular. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Familial Mediterranean fever (FMF) is the most common autoinflammatory disease characterized by short, repeated, and self-limiting attacks of fever and serositis. Subclinical inflammation can persist in the periods with no symptoms and result in amyloidosis even with colchicine treatment. Neopterin and calprotectin have been considered essential players in inflammation and immune response., Aim: The study was aimed to measure serum levels of neopterin and calprotectin in patients with FMF in the attack-free period., Methods: A total of 160 participants were recruited from the rheumatology department in this single-center, case-control study. Individuals having the inclusion criteria were divided into healthy controls (n = 80) and FMF (n = 80). The laboratory data were acquired from the electronic registration database. Serum calprotectin and neopterin were measured with ELISA test kits. FMF patients and healthy controls' laboratory findings were compared., Results: FMF patients' serum red cell distribution width (RDW), calprotectin, and neopterin values were significantly higher compared to healthy controls. There were no statistically significant differences between calprotectin and neopterin regarding gender, family history, and colchicine response of the FMF patients., Conclusions: Calprotectin, neopterin, and RDW can be valuable marker candidates to be used in the follow-up of subclinical inflammation in FMF patients., (© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Varicocele is abnormal tortuosity and dilatation of the pampiniform plexus veins within the spermatic cord. Varicocele is associated with testicular atrophy, hypogonadism, impaired semen analysis values, or decreased testosterone production. Varicocele is a progressive disease and should be treated because it may be a systemic disease that can be associated with cardiovascular abnormalities. We hypothesize in this study that cardiovascular and hemodynamic pathologies may occur in varicocele patients. In this prospective, multicentric, multidisciplinary study, patients diagnosed with high-grade left varicocele in the urology clinic underwent semen analysis, total testosterone determination, and scrotal Doppler ultrasonography. In addition, blood pressure measurement and echocardiographic evaluation were performed by blinded cardiologists in both the varicocele patients and the healthy control group. The study was carried out with 103 varicocele patients and 133 healthy individuals who formed the control group. Diastolic blood pressure (P = 0.016), left ventricular end diastolic (P < 0.001) and systolic diameter (P < 0.001), ejection fraction (P < 0.001), pulmonary arterial pressure (P < 0.001), and aortic distensibility (P < 0.001) values were significantly higher in varicocele patients compared with controls; interventricular septum wall thickness (P = 0.022), aortic systolic (P < 0.001) and diastolic diameter (P < 0.001), aortic systolic (P < 0.001) and diastolic diameter index (P < 0.001), and aortic stiffness index (P < 0.001) values were significantly lower in varicocele patients. The mean aortic distensibility of non-normozoospermic group was lower than that of normozoospermic group (P = 0.041). There was no statistically significant relationship between thickest vein diameter in spermatic cord and cardiological parameters. This study showed that symptomatic patients with high-grade varicocele had a higher risk of cardiovascular and hemodynamic disease. We recommend that men with high-grade symptomatic varicocele with impaired semen analysis undergo cardiovascular and hemodynamic evaluation regardless of their spermatic vein diameter.

Background: Familial Mediterranean fever (FMF) is an autoinflammatory syndrome characterized by recurrent episodes of fever and aseptic polyserositis. Subclinical inflammation generates a hidden threat to the development of FMF complications such as amyloidosis in attack-free intervals. The kynurenine pathway (KP) has been considered an important player in inflammation and immune response. The study was aimed to measure serum levels of KP metabolites in patients with FMF in the attack-free period., Methods: A total of 161 participants were recruited from the rheumatology department in this single-centre, case-control study. Participants meeting the eligibility criteria were divided into healthy controls (n = 80) and FMF (n = 81). The laboratory data were obtained from the electronic registration database. Serum tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), 3-hydroxyanthranilic acid, 3-hydroxykynurenine (3HK), and quinolinic acid (QUIN) concentrations were measured with tandem mass spectrometry. Laboratory findings of FMF patients and healthy controls subjects were compared and evaluated., Results: Serum TRP and KYNA levels were significantly decreased in both FMF groups compared to the control group, while the levels of KYN, QUIN, 3HK, the KYN/TRP ratio, and red cell distribution width were higher., Conclusion: TRP degradation by the KP is increased in patients with FMF. KP metabolites can be useful in demonstrating subclinical inflammation., (© Japan College of Rheumatology 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: This study aimed to evaluate primary Sjögren's syndrome patients in terms of hearing and vestibular functions., Methods: The patient group consisted of 35 individuals diagnosed with primary Sjögren's syndrome and a control group of 35 healthy individuals similar in terms of age and gender., Results: The rate of hearing loss in the patient group was significantly higher than in the control group ( p = 0.021). The N1 latency value for the ocular vestibular-evoked myogenic potentials test was significantly longer in the patient group than in the control group ( p = 0.037). Additionally, the posterior semicircular canal and lateral semicircular canal vestibulo-ocular reflex gain values were significantly lower than in the control group ( p = 0.022 and p < 0.001, respectively)., Conclusion: These results indicate subclinical vestibular involvement and hearing loss in primary Sjögren's syndrome patients. Vestibular-evoked myogenic potentials and video head impulse tests can be used to detect vestibular involvement in primary Sjögren's syndrome patients.

Background: Capparis ovata contains alkaloids, lipids, polyphenols, flavonoids, and also is rich in antioxidants. Conventionally, in Turkey, the flower buds, root, bark, and fruits of C. ovata are used for their analgesic, anti-inflammatory, anti-rheumatism, tonic, and diuretic effects. The aim of this study was to examine the effect on wound healing of C. ovata seed oil (COSO), which is known to have antioxidant, anti-inflammatory, and antibacterial properties., Methods: In the study, 20 Wistar albino female rats were randomly divided into two groups of 10 animals each. A standard full-thickness skin defect was created on the back area of the rats. In both groups, after cleaning the wounds with saline daily, no active substance other than saline was applied to the control group, while 1 cc/day COSO was applied to the wounds of the rats in the study group. On the post-operative 14th day, the rats were reanesthetized and wound area measurements were made. Then, excision was performed to include 1 cm of intact tissue around the wound, which remained unhealed, and samples were taken for histopathological examination., Results: The changes in wound areas showed that after 14 days, the improvement in the group treated with caper oil (32.78; 95% confidence interval, 17.21-48.36) was significantly higher than that of the control group (65.41; 95% confidence interval, 49.84-80.98) (p=0.009). The histopathological scores showed a significant difference between the groups in respect of epithelial formation, inflam-mation, and fibrosis development. No epithelial tissue formation was observed in the control group (90%), and more incomplete re-epithelization and focal epidermal hyperplasia were observed in the treatment group (60%). Fibrosis development was mild and weak (70%) in the control group and was evaluated as severe and intense (60%) in the treatment group. Perivascular edema was mild (50%) and vascularity was immature (60% - an indicator of neovascularization) in the treatment group. These histopathological results showed that the treatment group inflammation phase was completed and the proliferation phase started, as well as the effectiveness of the use of caper oil on epithelization, angiogenesis, and fibrosis, which are important histopathological parameters in the evaluation of wound healing compared to the control group., Conclusion: From the results of this study, it was concluded that COSO significantly enhances the healing of full-thickness skin wounds and this effect is primarily related to its anti-inflammatory effect.

Background: This study was designed to observe and compare the performance of fiberoptic laryngeal (FOL) view, leakage test (LT) and ultrasonography (USG) usage in detecting i-gel position in pediatric patients., Methods: One hundred ten consecutive children were included in this single-armed prospective observational study. After anesthetic induction, i-gel placement confirmed using FOL and LT was evaluated using USG in three planes. According to our scoring system, acceptable and unacceptable grades (FOL, LT and USG) were determined to describe placement. Sensitivity and specificity were determined by comparing USG performance with the other two tests., Results: Ultrasonography was found a sensitivity of 20% positive predictive value (PPV) for unacceptable i-gel placement according to FOL grade and a sensitivity of 37.04% with a 100% PPV according to LT grade. USG was found a specificity of 91.84% negative predictive value (NPV) of 91.84% for acceptable i-gel placement according to FOL grade and the NPV specificity of 100% with a 82.65% NPV according to LT grade., Discussion: Ultrasonography demonstrated a very good diagnostic performance in the detection of optimal i-gel placement according to both FOL and LT. However, both FOL and LT showed poor diagnostic performance compared to USG in demonstrating i-gel malposition.

Objective: Coronavirus disease 2019 is a major health problem in all age groups. Although most clinical symptoms are respiratory, gastrointestinal symptoms are often reported. This is a major concern for children and has limited research coverage. In this study, we evaluated the frequencies of gastrointestinal symptoms and liver biochemical findings in children with coronavirus disease 2019 and their relationship with clinical course and length of hospital stay., Materials and Methods: Demographic data, clinical, and laboratory findings of children with Coronavirus disease 2019 who were followed up by the Department of Pediatric Infectious Diseases between March 2020 and August 2020 were recorded. They were classified accord- ing to age groups as <5 years, 5-10 years, and >10 years. Laboratory findings were analyzed according to age groups. Demographic, clinical, and laboratory findings were compared in both situations, the presence of gastrointestinal symptoms and the presence of elevated liver enzymes. It was considered statistically significant if it was <.05., Results: A total of 294 patients (median age 10 years [14 days to 18 years]) were enrolled in this study. Although fever is the most common symptom of coronavirus disease 2019, 15.6% of patients presented with acute gastroenteritis. Most patients with liver involvement (n = 130, 44.2%) were under 5 years of age (n = 74, 56.9%, P <.001). The patterns of abnormal liver test results were cholestatic (71.5%), hepatocellular (18.4%), and mixed (10%) types. Severe or mas- sive elevation of aminotransferase or liver failure was not observed. No statistically significant difference was noted in outcomes, including length of stay, for patients with gastrointestinal symptoms (P = .178) or liver involvement (P = .146)., Conclusion: The presence of gastrointestinal symptoms or elevated liver enzymes does not affect the course of the disease in children with coronavirus disease 2019.

Objective: To evaluate the compatibility between ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT) scintigraphy and computed tomography pulmonary angiography (CTPA) in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH)., Subject and Methods: Twenty cases of CTEPH, out of 98 patients with pre-diagnosis of pulmonary hypertension (PH), who was diagnosed with CTEPH with a multidisciplinary approach and a council decision, were included in the study retrospectively. The diagnostic performances of V/Q SPECT and CTPA, which are used as noninvasive methods in diagnosing CTEPH, and the compatibility between them were calculated statistically., Results: Of 20 patients diagnosed with CTEPH, 12 were female, and 8 were male; the mean age was 59.1 (range: 36-79). The sensitivity of V/Q SPECT scintigraphy of imaging methods used to diagnose CTEPH was 90%, CTPA was 80%, specificities were 88% and 92%, respectively, and accuracy was 88% in both cases methods. According to the reference standard, the kappa value for V/Q scintigraphy was calculated as 0.765 and 0.678 for CTPA. These values were statistically significant (P<0.01), and there was a substantial concordance between them., Conclusion: There is significant compatibility between V/Q SPECT scintigraphy and CTPA in diagnosing CTEPH, whose differential diagnosis is essential because of its high cure potential due to PH causes.

Objective: In this prospective study, the diagnostic performance of the new version of superb microvascular imaging (SMI) in differentiating malignant from benign lesions was evaluated., Material and Methods: Ninety breast lesions were included. During color SMI examination, both free-hand region of interest (ROI) and box ROI were used. Vascular index (VI) values were obtained from the lesion using both types of ROI and from normal breast tissue via box ROI. VI values, monochrome SMI grading and histopathological results were compared. The efficacy of color SMI and monochrome SMI was investigated in differentiating between benign and malignant breast lesions., Results: The cut-off value, in the differentiation of benign and malignant lesions with color SMI was 0.50 for box ROI, while it was 0.30 for free-hand ROI. The specificity of VI values obtained with box ROI was higher than that of free-hand ROI when differentiating malignant lesions from benign. Comparison of VI values from a lesion and from normal breast tissue showed that VI values in malignant lesions were significantly higher (p<0.05). The VI values of benign lesions and VI values of normal breast tissue were similar. There was a statistically significant relationship between monochrome SMI grading and the malignancy or benign status of the lesion (p<0.001)., Conclusion: Drawing the lesion circumference free-hand using a free-shape ROI did not enhance the sensitivity and specificity. Contrary to popular belief, a more easy and practical measurement method may be more suitable for SMI examination. It is hoped that this will be one of the earliest studies to assess the clinical performance of the latest version of SMI., Competing Interests: Conflict of Interest: No conflict of interest declared by the authors., (©Copyright 2022 by Turkish Federation of Breast Diseases Associations.)

Objective: Interstitial lung disease (ILD) is one of the most severe complications which is associated with connective tissue disease (CTD) and causes to morbidity and mortality. So, we aimed to determine serum levels of interleukin-6 (IL-6), IL-13, and IL-17, to investigate whether these cytokines are related to CTD-ILD, and to find their possible contribution to determining the prognosis of the disease., Methods: A total of 150 participants, 80 patients diagnosed with CTD-ILD (mean age, 58.21 ± 12.36) and 70 healthy controls (mean age, 57.07 ± 9.60) were recruited from the rheumatology department between January 2016 and June 2019 in the study. High-resolution computed tomography (HRCT) findings were scored as similarly to previous studies. Serum IL-6, IL 13, and IL-17 levels were measured by ELISA test kits., Results: The levels of IL-6, IL-13, and IL-17 in CTD patients were significantly higher than the healthy individuals (p < 001), but the HRCT score's relation were not determined. IL-6 was associated with disease duration and disease activity scores of DAS28, ESDAII, and dSSc. There was a significant relation between dSSc, HCRT fibrosis, and total score.CRP, hemoglobin, and platelets were associated with the HRCT inflammation pattern., Conclusion: At the study, it has been observed that serum IL-13, IL-6 and IL-17 levels are increased in patients with CTD-ILD. Besides, IL-6 was associated with disease activity scores of DAS28, ESDAII, and dSSc. Also, HRCT fibrosis score is associated with dSSc. Further and comprehensive studies are needed to understand better the complex intersection of lung disease with systemic autoimmunity. Key Points • Serum IL-13, IL-6, and IL-17 levels are increased in patients with CTD-ILD. • IL-6 was associated with disease activity scores of DAS28, ESDAII, and diffuse skin involvement. • HRCT fibrosis score is associated with diffuse skin involvement in patients with SSc-ILD. • HRCT inflammation score is associated with PAH., (© 2021. International League of Associations for Rheumatology (ILAR).)

Objective: Behçet's Disease (BD) is a polygenic and chronic autoinflammatory multisystemic vasculitis disease characterised by mucocutaneous, musculoskeletal, neurological, gastrointestinal and ophthalmologic lesions. There has been no specific test or serum marker to measure and determine the diagnosis and severity of BD., Purpose: The study aimed to investigate the diagnostic performance of haematological parameters as MLR (monocyte to lymphocyte ratio), NLR (neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio), MPV (mean platelet volume), MPVPR (mean platelet volume to platelet ratio), LMR (lymphocyte to monocyte ratio), LPM (lymphocyte and platelet multiplication), WLP (lymphocyte and leukocyte multiplication), RDW (red blood cell distribution width) and PCT (plateletcrit) in BD and compare these with disease activity and clinical findings., Methods: A total of 266 participants (49 healthy control and 217 BD patients) were recruited from the rheumatology department in a single-centre as a case-control study. The laboratory data were obtained from the electronic registration database. BD Activity scores (BDCAF/Behcet's Disease Current Activity Form) were calculated. Laboratory findings of BD patients and healthy controls were compared and evaluated., Results: RDW, Platelet, PCT, NLR and PLR values were significantly higher in patient group than in the healthy controls. However, haemoglobin, MPVPR and LMR were significantly lower in the patient group which compared with the healthy controls. LPM in BD with genital ulcers, WLP in BD with genital ulcers and arthritis, MPR in BD with uveitis, RDW in BD with thrombosis and neuro-Behçet's disease (NBD), PLR in NBD were observed to be higher. However, LMR in NBD and MPV in BD with thrombosis were lower than those without. There was a positive correlation between BDCAF score and RDW, and NLR., Conclusion: Haemoglobin, RDW, Platelet, PCT, NLR, LMR, PLR and MPVPR were statistically significant predictors for BD. RDW, PCT and NLR are the most valuable predictors for BD., (© 2021 John Wiley & Sons Ltd.)

Introduction: In this study, our aim was to prospectively compare the different methods of patient disinfections with scrubbing + iodine + alcohol, and the povidone iodine disinfection method, which can be described as classical, in terms of the pathogens isolated on skin and during early postoperative complications., Methodology: Eighty patients undergoing a coronary artery bypass operation were included in the study. The patients were divided into two groups: group 1 (n = 48) patients who underwent scrub, iodine, followed by skin disinfection with alcohol, and group 2 (n = 32) who were treated with povidone iodine three times. The samples were immediately sent to the microbiology laboratory. Specimens from the wounds were incubated under aerobic and anaerobic conditions, and isolates were identified using standard microbiological techniques., Results: In samples taken after disinfection in group 1, significantly less reproduction was observed compared to group 2 (p = 0.001). There was no difference in postoperative complications between the two groups except for pleural effusion (p = 0.040). S. epidermidis was the most frequently isolated pathogen in both groups., Conclusion: We did not find a study which compares scrub + alcohol + iodine and povidone iodine in our literature review. We think that our study is original in this respect. We can conclude that skin disinfection with scrub + alcohol + iodine was superior to using only povidone iodine in terms of the pathogens isolated afterwards from the wound., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Murat Gunday, Atilla Orhan, Hale Turan, Muslu Kazım Korez.)

Purpose: Our study aimed to evaluate the effects of chronic hypoxic state in Obstructive Sleep Apnea Syndrome (OSAS) on brainstem pathways using Vestibular Evoked Myogenic Potential (VEMP) test and to investigate the presence of new markers likely to be correlated with the severity of the disease., Methods: The study was planned as prospective and double blind. A total of 60 patients (120 ears) diagnosed with mild, moderate and severe OSAS were included in the study and the patients are grouped as 20 patients in each group. Twenty volunteer healthy individuals (40 ears) shown to be without OSAS were included in the study. VEMP measurements were made in 60 study group patients (120 ears) and in 20 healthy controls (40 ears). The groups were compared in terms of variables such as the acquisition rate of oVEMP and cVEMP waves, interval between the waves, latency and amplitude of the waves. p < 0.05 values were considered as significant., Results: The results of cVEMP test showed that the rate of wave acquisition in the moderate and severe OSAS groups was significantly lower than the control group and mild OSAS groups (p = 0.008). There was no difference between the control group and the mild OSAS group in terms of the rate of obtaining the wave (p > 0.05). In the moderate and severe OSAS groups, P1N1 amplitude and N1P2 amplitude values were found to be significantly lower than the mild OSAS group (p = 0.007 and p = 0.017, respectively). In the oVEMP test, there was no significant difference between the mild OSAS group and the control group in terms of the wave yield (p > 0.05); however, it was found that the rate of wave acquisition in the moderate and severe OSAS groups was significantly lower than the mild OSAS group (p = 0.041). There was inverse correlation between the N1P2 interval and P1N1 amplitude value and AHI in simple regression analysis and multiple regression analysis (p = 0.012 and p = 0.021; p = 0.009 and p = 0.040, respectively)., Conclusion: The negative effects of chronic intermittent hypoxia related with OSAS on the brainstem and vestibular system can be demonstrated by VEMP tests. Especially, the inability to obtain the wave is the most important finding showing this situation. Also, we think that N1P2 interval and P1N1 amplitude markers can be used to detect the subclinical negative effect of chronic hypoxia on vestibular nuclei in the brainstem.

Background: The aim of the present study was to establish the normal ranges for foetal nasal bone length (NBL), prenasal skin thickness (PNT), interocular distance (IOD), and ratio of prenasal thickness to- nasal bone length (PNT/ NBL) at 18-24 weeks using two-dimensional (2D) ultrasound., Methods: This study was a retrospective study of prenatal ultrasonographic records from 407 foetuses between 18 and 24 weeks gestational age (GA). The NBL, PNT, IOD, PNT/ NBL ratio, biparietal diameter (BPD), and femur length (FL) were investigated. The relationships among NBL, PNT, IOD, PNT/ NBL, and GA were evaluated. Additionally, descriptive statistics for NBL, PNT, and IOD values for each gestational week were obtained., Results: There was a significant association between GA and NBL, PNT, and IOD between 18 and 24 weeks. NBL increased from a mean of 5.5 mm to 8.3 mm, PNT increased from a mean of 3.5 mm to 5.1 mm, and IOD increased from a mean of 11.1 mm to 14.5 mm. PNT/NBL ratio did not change with gestational age., Conclusions: This study showed normal ranges for NBL, PNT, IOD, and PNT/ NBL ratios for foetuses between 18 and 24 weeks in low-risk pregnancies. There was a positive linear relationship between GA and NBL, PNT, and IOD. The PNT/NBL ratio might be a more useful measurement than NBL or PNT alone.

Background: Mammography is essential for early diagnosis of breast cancer, which is the most common type of cancer in females that is associated with a high mortality rate. We investigated whether evaluation of the grayscale inverted images of mammograms would aid in increasing the diagnostic sensitivity of the mammographic imaging technique., Methods: Our study included 636 mammograms of 159 women who had undergone digital mammography. Standard, grayscale inverted, and standard plus grayscale inverted images were sequentially examined three times, at 15-day intervals, for the presence or assessment of pathological changes in the skin, calcification, asymmetric density, mass lesions, structural distortions, and intramammary and axillary lymph nodes. To determine whether grayscale inverted image assessment improved detection rates, the results of the three assessment modes were compared using Cochran's Q test and the McNemar test (p < 0.05 was considered statistically significant)., Results: The average age of 159 patients was 50.4 years (range, 35-80 years). There were significant differences among the three assessment modes with respect to calcification and intramammary lymph nodes (p < 0.05); however, no significant differences were observed for the detection of other parameters., Conclusions: Assessment of grayscale inverted images in addition to standard images facilitates the detection of microcalcification.

Objectives: Ramadan is a holy month in which eating and drinking are forbidden from dawn to sunset. In this study, we investigated using ultrasonography (USG) whether fasting in summer (as occurred in Ramadan 2014) had an influence on the volume of amniotic fluid during pregnancy., Materials and Methods: The study included 119 pregnant women in total who were admitted to our department with a request of obstetric USG between June 28, 2014, and July 27, 2014. The fasting group included 61 pregnant women and the control group of 58 pregnant women. In our study, all the fasting pregnant women had Sahur (predawn meal eaten before starting fasting) and Iftar (the evening meal for fast-breaking) every day, regularly. The women in the control group did not fast. In addition to amniotic fluid index and fetal biometric measurements during Ramadan, amniotic fluid volume was measured ultrasonographically throughout pregnancy. All ultrasound examinations were performed at least 8 h after Sahur during Ramadan. Chi-square test was utilized to compare the measurements of amniotic fluid volume, and Mann-Whitney U-test was utilized to analyze the differences in fetal growth data. Moreover, difference was considered statistically significant when the P value was <0.05., Results: The mean age was 25.7 years in the fasting group and 25.8 years in the control group. Other characteristics and mean gestational weeks of the two groups were similar. Ultrasonographically, there was no significant difference between two groups in respect to amniotic fluid amount during pregnancy (P = 0.7). There was no significant difference with regard to fetal growth parameters either (P > 0.05)., Conclusion: In pregnant women who had regular predawn and fast-breaking meals, fasting in summer did not elicit alteration in the amount of amniotic fluid throughout pregnancy.