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Tugrul Bulut,1 Merve Gursoy,2 Tahir Ozturk,1 Cem Ozcan,1 Muhittin Sener1 1Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey; 2Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Objective: The aim of this study was to determine whether tri-cortical iliac bone autografting provided extra benefit for the stabilization in Sanders Type 3–4 calcaneal fractures fixed with locking plate. Materials and methods: The study included 29 calcaneal fractures (Sanders Type 3/4=15/14). All fractures were fixed with locking plate using the extended lateral approach. Bone grafts were used in 16 (Group A; Sanders Type 3/4=7/9) and not used in 13 (Group B; Sanders Type 3/4=8/5) calcaneal fractures. As a grafting material, only tri-cortical iliac crest bone autograft was used. All operations were performed by the same surgeon. The same locking plate was used in all fractures. Calcaneal height and angle of Bohler and Gissane were measured in early postoperative and final control radiographs in both groups. Clinical evaluations were performed using the American Orthopedic Foot and Ankle Society ankle hind foot scale. Results: There was no difference between the groups in terms of clinical results. Radiologically, the degree of change in Bohler’s angle, Gissane’s angle, and calcaneal height was not different between the groups. Conclusion: Bone grafting does not affect the clinical and radiologic outcomes in Sanders Type 3–4 calcaneal fractures fixed with locking plate, and they provide no extra benefit to the stabilization. We think that fixation using locking plate is adequate and there is no need for bone grafting. Keywords: calcaneal fractures, Sanders Type 3–4, locking plate, bone autograft

Members of the SAR11 order Pelagibacterales dominate the surface oceans. Their extensive diversity challenges emerging operational boundaries defined for microbial 'species' and complicates efforts of population genetics to study their evolution. Here, we employed single-amino acid variants (SAAVs) to investigate ecological and evolutionary forces that maintain the genomic heterogeneity within ubiquitous SAR11 populations we accessed through metagenomic read recruitment using a single isolate genome. Integrating amino acid and protein biochemistry with metagenomics revealed that systematic purifying selection against deleterious variants governs non-synonymous variation among very closely related populations of SAR11. SAAVs partitioned metagenomes into two main groups matching large-scale oceanic current temperatures, and six finer proteotypes that connect distant oceanic regions. These findings suggest that environmentally-mediated selection plays a critical role in the journey of cosmopolitan surface ocean microbial populations, and the idea ‘everything is everywhere but the environment selects’ has credence even at the finest resolutions.

Background/Aims: Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases. Along with the increase in myeloproliferative cell lines, they can cause various clinical outcomes such as arterial and venous thrombosis, pulmonary hypertension, and myocardial infarction. This study was designed to evaluate the cardiac effects of these diseases via electrocardiography and echocardiography. Methods: A total of 50 patients with a diagnosis of PV, 50 patients with a diagnosis of ET, and 50 healthy individuals as a control group were included in this study. Data on patient demographics were recorded in all subjects. All patients and control subjects had electrocardiography (ECG) recordings and routine transthoracic echocardiographic examination. Pulse wave velocity (PWV) was assessed with a Holter blood pressure device. Results: In total, 50 PV patients, 50 ET patients, and 50 control group were included in the study. The demographic characteristics of the PV, ET and control groups were similar. The PR interval was significantly shorter in control subjects than in PV and ET patients (p:0.007, p:0.024). Although the measured values were within normal limits, diastolic posterior wall thickness was significantly lower in the control group compared to PV and ET patients (p:0.019, p:0.009). PWV was significantly higher in ET patients compared to the control group (p:0.012). Conclusion: In this study, evaluating the effects of PV and ET on electrocardiography and transthoracic echocardiography; ECG parameters used to predict ventricular arrhythmias (QT, QTc, Tp-Te, Tp-Te/QT) and Pulmonary Artery Pressure showed no significant change, in opposition to existing literature. Nonetheless, similar to previous publications, PV and ET were found to negatively affect the diastolic function parameters on transthoracic echocardiography. While the aortic stiffness was significantly higher in ET patients compared to the control group, no significant difference was noted between PV patients and control subjects in terms of aortic stiffness.

Objective: This study aimed to evaluate patients with relapsed/ refractory multiple myeloma (RRMM) who underwent daratumumab (DARA) therapy. Materials and Methods: This multicenter retrospective study included 134 patients who underwent at least two courses of DARA from February 1, 2018, to April 15, 2022. Epidemiological, disease, and treatment characteristics of patients and treatment-related side effects were evaluated. Survival analysis was performed. Results: The median age at the start of DARA was 60 (range: 35-88), with 56 patients (41.8%) being female and 48 (58.2%) being male. The median time to initiation of DARA and the median follow-up time were 41.2 (5.1- 223) and 5.7 (2.1-24.1) months, respectively. The overall response rate after DARA therapy was 75 (55.9%), and very good partial response or better was observed in 48 (35.8%) patients. Overall survival (OS) and progressionfree survival (PFS) for all patients were 11.6 (7.8-15.5) and 8.0 (5.1-10.9) months, respectively. OS was higher for patients undergoing treatment with DARA and bortezomib-dexamethasone (DARA-Vd) compared to those undergoing treatment with DARA and lenalidomide-dexamethasone (DARA-Rd) (16.9 vs. 8.3 months; p=0.014). Among patients undergoing DARA-Rd, PFS was higher in those without extramedullary disease compared to those with extramedullary disease (not achieved vs. 3.7 months; odds ratio: 3.4; p

Objective: The discovery of imatinib was a milestone for chronic myeloid leukemia (CML). As the life expectancy of CML patients has approached that of the general population, research has shifted towards improving quality of life and economic considerations. After 2010, it was shown that some patients could maintain molecular response even after discontinuing imatinib. This national multicenter prospective cohort study aimed to observe the long-term consequences of discontinuing imatinib therapy in adult chronicphase CML patients. Materials and Methods: We enrolled 41 CML patients from 4 different centers in this non-randomized single-arm trial. Molecular responses of all patients were re-evaluated using real-time polymerase chain reaction at a single center. The median follow-up time after imatinib discontinuation was 48 months (minimum-maximum: 6-81 months). Results: The rate of molecular relapse-free survival at 48 months was 33.2% (confidence interval: 48.2-18.2). Twenty-seven of 41 patients lost their major molecular response, treatment was started again, and deep molecular response was re-achieved with imatinib in all cases. There was no significant relationship between molecular relapse and clinical factors such as duration of treatment or molecular response status. Discontinuing imatinib resulted in savings of approximately 4,392,000 Turkish lira or 245,150 US dollars. Conclusion: Tyrosine kinase inhibitor discontinuation with close molecular monitoring is a safe option and provides important national economic benefits for chronic phase CML patients. This approach should be considered for all eligible patients. This is the first tyrosine kinase inhibitor discontinuation study from Türkiye.

OBJECTIVE: In vitro fertilization failure (IVF) is high in women with poor ovarian response or non-responder. For this reason, the addition of adjuvant treatments to IVF protocols has come to the fore. We assessed to investigate the effects of adjuvant GH therapy initiated in the mid-luteal phase on IVF success in poor ovarian response or non-responder women. PATIENTS AND METHODS: A retrospective study was performed in 93 poor ovarian response or non-responder women from a single center. GH treatment was added (GH-plus group) in the mid-luteal phase of the previous menstrual cycle to 47 of the women who underwent controlled ovarian stimulation with the flexible antagonist protocol. 46 women, as another group, were applied to a flexible antagonist-only protocol (GH-free group). The IVF outcome results were evaluated and compared within the groups. RESULTS: The number of retrieved oocytes was statistically significantly higher in the GHplus group (2.28±1.975) than in the GH-free group (1.24±1.728) (p=0.01). Although statistically insignificant (p=0.55), the clinical pregnancy rate was higher in the GH-plus group [(8/47), 17%] than in the GH-free group [(5/46, 11%]. The cancellation rate was statistically significantly higher in the GH-free group (65.2%) than in the GHplus group (44.7%) (p=0.04). No oocyte retrieved cycle rate was higher in the GH-free group (56%) than in the GH-plus group (25%) (p=0.002). CONCLUSIONS: Adjuvant GH therapy administration to IVF protocol in the mid-luteal phase gives poor ovarian response or non-responder women a chance to have a baby. [ABSTRACT FROM AUTHOR]

Aim:In this study, it was aimed to compare serum periostin levels of patients with and without bone marrow fibrosis among newly diagnosed multiple miyeloma (MM) patients.Materials and Methods:Thirty patients who were diagnosed with fibrosis in bone marrow biopsy from 36 MM patients over the age of 18 who were newly diagnosed in our center in line with the recommendations of national and international guidelines and were selected for serum periostin levels were included in the study. The patients were divided into two groups as those with and without fibrosis.Results:While the serum periostin level of the patients with bone marrow fibrosis was 29.22 ng/mL, the serum periostin level of the patients without fibrosis was 17.97 ng/mL, which was statistically significantly higher (p

OBJECTIVE: Multiple sclerosis (MS) is a demyelinating, chronic, and progressive autoimmune disease of the central nervous system that causes the loss of axons and grey matter, and has a high prevalence in young female patients. Fingolimod is an oral treatment agent that acts by blocking the passage of the T lymphocytes responsible for the pathogenesis of MS from lymphoid tissue into the peripheral blood. We aimed to research the effects of menstrual cycles on leukocytes and lymphocyte levels in RRMS (relapsing-remitting MS) patients who received fingolimod treatment. PATIENTS AND METHODS: This study was performed to determine the most suitable phase of the menstrual cycle in patients with RRMS for follow-up assessment of lymphopaenia levels after fingolimod treatment. The study population consisted of 41 RRMS patients receiving fingolimod therapy and 33 healthy women of reproductive age. Complete blood counts were performed in three different phases of the menstrual cycle, and the two groups were compared. Variability in the total leukocyte, lymphocyte, and neutrophil immune cell numbers between cycles was examined. RESULTS: The results indicated that total leukocyte, neutrophil, and lymphocyte levels were decreased in RRMS patients receiving fingolimod treatment, but these changes were not related to the phase of the menstrual cycle. In our study, leukocyte levels in healthy individuals were significantly lower in the proliferative phase than in other phases. CONCLUSIONS: The results indicated that lymphocyte monitoring in RRMS patients receiving fingolimod treatment can be performed at any stage of the menstrual cycle. [ABSTRACT FROM AUTHOR]

This study was aimed at determining the effects of various levels of dietary olive cake meal (OCM) on certain blood parameters and breast muscle fatty acid and cholesterol levels. For this purpose, 400 day-old Japanese quail (Coturnix coturnix japonica) chicks of both sexes were randomly assigned to four trial groups, each including five replicates of 20 animals. The quail were fed on a maize and soybean meal-based basal diet supplemented with 0%, 2.5%, 5% and 7.5% of OCM for six weeks. Dietary supplementation with 5% and 7.5% of OCM decreased total cholesterol and low-density lipoprotein cholesterol levels in the blood serum, and increased cholesterol levels in the breast muscle. Dietary supplementation with various levels of OCM decreased saturated fatty acid and polyunsaturated fatty acid levels, and increased monounsaturated fatty acid and total unsaturated fatty acid levels in the breast muscle. As a result, it was concluded that, olive cake meal, which contains a high level of olive oil, could be incorporated in poultry feed at a level of 5%, owing to its beneficial effects of decreasing serum LDL cholesterol, which plays a major role in the aetiology of cardiovascular diseases, and in reducing saturated fatty acid levels in breast muscle. [ABSTRACT FROM AUTHOR]

We propose a new method to select the dispersion curve of Rayleigh and Love surface waves obtained from local and regional earthquakes. This method is efficient for the crustal tomography studies and the Central Anatolia is chosen to test it. The single-station method utilizing both seismograms and accelerograms is used for the group velocities from local earthquakes while the two-station approach utilizing the cross correlograms is employed for the group and phase velocities using both local and regional earthquakes. The proposed method is made of two stages. The first stage based on the multiple filter technique – MFT is designed for an automatic selection of the desired dispersion curve. In case of the single-station approach, the MFT diagrams are computed for both Rayleigh and Love seismograms or accelerograms. An algorithm based on several selection criteria is employed to extract the corresponding group velocity dispersion curve from the MFT diagram. In case of the two-station method, the MFT diagrams are computed for both Rayleigh and Love cross correlograms. The latter algorithm developed for the MFT diagram is again applied to the cross correlogram to select the respective two-station group velocity dispersion curve. To select the corresponding two-station phase velocity dispersion curve, another algorithm is developed where the joint inversion of phase and group velocities is employed. The RMS value quantifying the misfit between the selected and inverted dispersion curves is found minimum when the selected phase velocity curve is compatible with the group velocity curve extracted via the MFT. The selection procedures defined up until this point constitute the first stage. In the second stage, phase and group velocity gathering around base pathways is performed. This way it is possible to compute the averages and standard deviations for the observed pathways traversing the similar geology. The outliers determined by using the averages and standard deviations are eliminated from the data set and this elimination is performed for phase and group velocities, separately.