Search

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.Setting Prospective, international, multicentre, observational cohort study.Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration number NCT04323644

Background & objectives: Bioreactors are practical tools that are used for economical, time-conserving and large-scale production of biomass from cell cultivation. They provide optimal environmental conditions such as pH and temperature required for obtaining maximum amounts of biomass. However, there is no evidence in the literature on the large-scale cultivation of Leishmania infantum parasites in the bioreactor. Therefore, the present study was undertaken to develop a new approach for obtaining L. infantum biomass by using pH and temperature controllable stirred bioreactor and to compare parasitic growth kinetics with classical method within erlenmeyers. Methods: In order to obtain parasite biomass, a newly developed pH and temperature controlled stirred bioreactor was used and its efficacy was compared with a graduated classical scale-up method. Growth kinetics of parasites within erlenmeyers and bioreactors were determined by evaluating promastigote numbers using haemocytometer. The graduated scale enlargement of culture was followed by T25 flask, T75 flask, and 1 L erlenmeyer, respectively. Results: Obtained results showed a 10-fold increase in the number of promastigotes within the conventional culture performed in 700 ml medium, while parasite numbers increased approximately 15 times due to initial inoculation amounts in the bioreactor culture performed in the 3.5 l medium. Thus, there was 7.5 times more biomass collection in bioreactor compared to classical method. Interpretation & conclusion: It is postulated that constant culture pH and temperature in the bioreactor extends cultivation time. This could lead to significant increase in parasite numbers. Hence, pH and temperature controllable bioreactors provided acquisition of sufficient amounts of biomass in contrast to classical methods. Therefore, this type of bioreactors may substitute classical culture methods in the production of antigenic molecules for vaccine development.

Background: Monitoring of chemokines, CXCL9 and CXCL10, in serum may present a non-invasive detection method for rejection. Objective: To investigate the relationship between urinary levels of CXCL9 and CXCL10 and graft function following renal transplantation. Methods: 75 living-related donor renal transplant recipients were studied. Urinary levels of chemokines were collected pre-operatively, on post-operative 1st day, 7th day, 1st month, 3rd month, and at the time of rejection. Chemokines levels were assayed using and enzyme-linked immunosorbent assay. Results: Clinical variables were monitored. 10 (15%) patients had biopsy-proven rejection during the follow-up period. The urinary CXCL9 level in those with rejection was significantly higher than that in those with non-rejection group at the 1st day (p

In California's semi-arid climate, replenishment of groundwater aquifers relies on precipitation and runoff during the winter season. However, climate projections suggest more frequent droughts and fewer years with above-normal precipitation, which may increase demand on groundwater resources and the need to recharge groundwater basins. Using historical daily streamflow data, we developed a spatial index and rating system of high-magnitude streamflow availability for groundwater recharge, STARR, in the Central Valley. We found that watersheds with excellent and good availability of excess surface water are primarily in the Sacramento River Basin and northern San Joaquin Valley. STARR is available as a web tool and can guide water managers on where and when excess surface water is available and, with other web tools, help sustainable groundwater agencies develop plans to balance water demand and aquifer recharge. However, infrastructure is needed to transport the water, and also changes to the current legal restrictions on use of such water.

The complex index of refraction in the spectral range of 0.74 to 4.5 eV is studied by variable-angle spectroscopic ellipsometry in ferroelectric K0.5Na0.5NbO3 films. The 20-nm-thick cube-on-cube-type epitaxial films are grown on SrTiO3(001) and DyScO3(011) single-crystal substrates. The films are transparent and exhibit a significant difference between refractive indices Δn = 0.5 at photon energies below 3 eV. The energies of optical transitions are in the range of 3.15-4.30 eV and differ by 0.2-0.3 eV in these films. The observed behavior is discussed in terms of lattice strain and strain-induced ferroelectric polarization in epitaxial perovskite oxide films.

Early determination of antibacterial susceptibility increases the success of therapy, decreases unnecessary use of antibacterial agents and side-effects, and lowers the overall healthcare cost. We have evaluated a rapid antibacterial susceptibility test, Qui-Sensitest (Salubris Inc., Istanbul, Turkey), which is based on a rapid culture medium that indicates growth by changing its color. Qui-Sensitest proved to be a reliable rapid test for determining antibacterial susceptibility having an overall agreement of 97.6% with Kirby Bauer disk diffusion test results for enteric bacteria with 0.4% of major discrepancies and 2.0% of minor discrepancy. Since the test makes the results available in 3.5-6 hours, it can provide the means for choosing the right treatment regimen the same day the infectious agent is isolated.

Periodontitis is a bacterial inflammatory disease leading to attachment loss with the consequence of tooth loss. There exists a multifactorial risk pattern including bacterial challenge, smoking, age, sex, diabetes, socio-economic and genetic factors. Smoking has the highest impact on the course of the disease modulated by all the other factors. Here, we report the relationship between smoking and the polymorphisms of genetic polymorphisms inflicted in the pathogenesis. In a randomly selected population-based study, 1083 subjects were typed for the polymorphisms of the IL-1 genotype, FcγRIIIb receptor gene, myeloperoxidase and Nacetyltransferase (NAT2) and related to their periodontal state. Smoking behavior was assessed including present and past quality and quantity of smoking. There is a significant dose-effect relationship between the exposure to tobacco smoke and the extent of periodontal disease assessed as attachment loss and tooth loss. Moreover, there are gene-environmental interactions as subjects bearing variant genotypes show an enhanced smoking-associated risk of the disease modulated by these genotypes. In nonsmokers, the impact of these genetic polymorphisms is mostly negligible. This study provides support for the hypothesis that subjects bearing genetic variants of polymorphically expressed phenotypes are at an increased risk of periodontitis when smoking. Mostly, this may be accomplished via the influence of smoking-related impairment on defense mechanisms rather than on the pathogenic pathways.

Very large lattice strain and strain-induced polarization are achieved in KNbO _3 using epitaxial growth of a thin KNbO _3 film onto a (001)-oriented SrTiO _3 single-crystal substrate. We demonstrate experimentally that epitaxy produces dramatic changes of interband transitions in the film compared to those of a reference KNbO _3 crystal: the energies of transitions change, some transitions are substantially suppressed and new ones appear in the film. A comparison of the experimental observations with theoretical calculations points to yet unexplored phenomena. Our results indicate that optical refraction and electro-optical coefficients of ferroelectric films can be controlled by epitaxial growth, which is of importance for emerging photonic and optoelectronic applications.

The study of superconductivity with unconventional order is complicated in condensed matter systems by their extensive complexity. Optical lattices with their exceptional precision and control allow one to emulate superfluidity avoiding many of the complications of condensed matter. A promising approach to realize unconventional superfluid order is to employ orbital degrees of freedom in higher Bloch bands. In recent work, indications were found that bosons condensed in the second band of an optical chequerboard lattice might exhibit p _x ± i p _y order. Here we present experiments, which provide strong evidence for the emergence of p _x ± i p _y order driven by the interaction in the local p-orbitals. We compare our observations with a multi-band Hubbard model and find excellent quantitative agreement.

Background : This study evaluated the prognostic impact of Trop-2, CD47, and CD163 expression on clinical outcomes in triple-negative breast cancer (TNBC) and investigated their interactions with tumor progression. Methods : A retrospective cohort of 92 patients with TNBC was analyzed. The expression scores for Trop-2, CD47, and CD163 were categorized as negative/low (0-3 points) or high (4-6 points). The primary endpoint was overall survival (OS). Results : The median age of the cohort was 50 years old. High Trop-2 expression was observed in 55.4% of the patients and was significantly associated with advanced disease stage ( p < 0.001). High CD47 expression (44.6%) was correlated with advanced stage ( p = 0.044), whereas high CD163 expression (45.7%) was associated with advanced stage ( p = 0.021), absence of comorbidities ( p = 0.022), and lower pT stage ( p = 0.023). Moderate positive correlations were found between Trop-2 and CD47 ( p = 0.022), Trop-2 and CD163 ( p = 0.037), and CD47 and CD163 ( p < 0.001), respectively. Kaplan-Meier survival analysis revealed that patients with low Trop-2 expression exhibited significantly prolonged OS ( p = 0.021) and progression-free survival (PFS) ( p = 0.026) compared to those with high Trop-2 expression. Univariate and multivariate analyses revealed significant associations between OS and PFS for Trop-2, lymphovascular invasion, and BRCA status. Conclusions : Trop-2 expression is a significant prognostic factor for TNBC and is correlated with worse outcomes. Although CD47 and CD163 showed trends for poorer prognosis, their significance was not confirmed. These findings offer promising prospects for future studies on combined antibody-drug conjugates (ADCs), as they may present opportunities to address multiple resistance mechanisms in the management of TNBC and enhance clinical outcomes.

Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture. Secondary aims were to assess the variation in the provision of chemical prophylaxis and risk factors for VTE., Methods: This was a multicentre, prospective national collaborative audit with data collection over nine months for all patients undergoing foot and ankle surgery in an operating theatre or TA rupture treatment, within participating UK hospitals. The association between VTE and thromboprophylaxis was assessed with a univariable logistic regression model. A multivariable logistic regression model was used to identify key predictors for the risk of VTE., Results: A total of 13,569 patients were included from 68 sites. Overall, 11,363 patients were available for analysis: 44.79% were elective (n = 5,090), 42.16% were trauma excluding TA ruptures (n = 4,791), 3.50% were acute diabetic procedures (n = 398), 2.44% were TA ruptures undergoing surgery (n = 277), and 7.10% were TA ruptures treated nonoperatively (n = 807). In total, 11 chemical anticoagulants were recorded, with the most common agent being low-molecular-weight heparin (n = 6,303; 56.79%). A total of 32.71% received no chemical prophylaxis. There were 99 cases of VTE (incidence 0.87% (95% CI 0.71 to 1.06)). VTE-related mortality was 0.03% (95% CI 0.005 to 0.080). Univariable analysis showed that increased age and American Society of Anesthesiologists (ASA) grade had higher odds of VTE, as did having previous cancer, stroke, or history of VTE. On multivariable analysis, the strongest predictors for VTE were the type of foot and ankle procedure and ASA grade., Conclusion: The 90-day incidence of symptomatic VTE and mortality related to VTE is low in foot and ankle surgery and TA management. There was notable variability in the chemical prophylaxis used. The significant risk factors associated with 90-day symptomatic VTE were TA rupture and high ASA grade., Competing Interests: J. Mangwani reports support from the Leicester Hospitals Charity, related to this study. J. Mangwani reports payment or honoraria for lectures, presentations, educational events from Orthosolutions, and royalties from Meshworks, unrelated to this study. K. Malhotra reports payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from NewClip Technics, unrelated to this study. L. W. Mason reports royalties or licenses, consulting fees, and patents planned, issued or pending from Orthosolutions, unrelated to this study., (© 2024 The British Editorial Society of Bone & Joint Surgery.)

(1) Background: This qualitative study explores Division III college student-athletes' experiences and perceptions of personalized nutrition plans in collegiate sports settings. (2) Methods: Semi-structured interviews were conducted using a general qualitative research design. Using a grounded theory approach, a thematic analysis was utilized to analyze the interview transcripts, allowing for the identification of recurring themes and patterns. (3) Results: A total of 30 Division III college student-athletes, 16 males (53.3%) and 14 females (46.7%), representing a diverse range of sports disciplines, engaged in discussions about personalized nutrition plans. Analysis of the data revealed five main themes: (1) Nutritional Knowledge and Awareness, (2) Perceived Benefits of Personalized Nutrition Plans, (3) Challenges and Barriers to Implementation, (4) Influence of Team Culture and Environment, and (5) Suggestions for Improvement. (4) Conclusion: This study sheds light on the complexities of implementing personalized nutrition plans in collegiate sports settings and emphasizes the need for comprehensive, athlete-centered approaches to optimize performance and well-being.

Background: Research has demonstrated concussion likely causes autonomic dysfunction leading to exercise intolerance., Objective: To measure improvement in exercise intolerance due to suspected dysautonomia associated with protracted concussion recovery, using objective measurements on a Buffalo Concussion Treadmill Test (BCTT) following participation in a prescribed exercise program., Methods: This is a retrospective cohort study of 101 patient charts post-concussion. Exercise intolerance was assessed using a BCTT to identify suspected dysautonomia and an exercise prescription was provided using guidelines for treating concussion-associated exercise intolerance. Patients without symptom improvement and/or inability to achieve 80-85% of age-expected maximum heart rate (HR) without symptom exacerbation received a repeat BCTT., Results: Twelve patient charts met inclusion criteria and were included in data analysis. There were significant improvements from pre-intervention to post-intervention testing in: maximum BCTT stage mean scores (p = .02); maximum HR mean scores (p = .01); prescription HR (RxHR) mean scores (p = .01); and HR delta (HR δ ) mean scores (p = .00)., Conclusions: Maximum stage, HR threshold, RxHR, and newly identified HR delta (HR δ ) are potential objective measurements of progress for dysautonomia treatment post-concussion. Future studies are indicated to create a tailored protocol in the management of protracted concussion-associated dysautonomia.

Purpose: The aim of this study is to compare the biocompatibility of two different resin composites after polymerization under two different light sources in three different time periods., Materials and Methods: 72 polyethylene tubes polymerized with 2 different resin composites and 2 different light sources (Elipar S10 and Valo ) [Group 1: Kalore Elipar S10 (KE), Group 2: Kalore Valo (KV), Group 3: Essentia Elipar S10 (EE), Group 4: Essentia Valo (EV)] were implanted in the dorsal connective tissue of 18 rats. 24 empty polyethylene tubes [Group 5: (Control group)] were implanted in the dorsal connective tissue of 6 rats. Then, the rats were sacrificed after 7th, 15th and 30th days in each time intervals (n=8). Biopsy samples were stained with H&E and examined for inflammation, necrosis, macrophage infiltrate, giant cell and fibrous capsule criteria. Immunohistochemical staining was performed to evaluate proinflammatory cytokines (IL-1β, IL-6 and IL-8)., Results: When the composite groups and the control groups were compared; the difference was statistically significant for the criteria of inflammation at 7th and 15th days, there was no statistical difference between the time points in terms of fibrous capsule and necrosis. When the composite groups and control groups were evaluated in terms of proinflammatory cytokines; statistically significant differences were found at 7th, 15th and 30th days., Conclusion: All CRs used in this study showed acceptable biocompatibility in the subcutaneous tissues of rats after polymerization with different light sources., Competing Interests: Conflict of interest:The authors declare that they have no conflict of interest., (Copyright © 2024 European Oral Research.)

In this study, it was aimed to elucidate the interaction between aryl hydrocarbon receptor (AHR), nuclear factor-kappa B (NF-kB), and cytochrome P4501A1 (CYP1A1) with hepatitis B virus X protein (HBX) in a human liver cancer cell line (HepG2) transfected with HBX. First, AHR, NF-kB, and CYP1A1 genes were cloned into the appropriate region of the CheckMate mammalian two-hybrid recipient plasmids using a flexi vector system. Renilla and firefly luciferases were quantified using the dual-luciferase reporter assay system to measure the interactions. Secondly, transient transfections of CYP1A1 and NF-kB (RelA) were performed into HBX-positive and HBX-negative HepG2 cells. The mRNA expression of CYP1A1 and NF-kB genes were confirmed with RT-PCR, and cell viability was measured by WST-1. Further verification was assessed by measuring the activity and protein level of CYP1A1. Additionally, CYP1A1/HBX protein-protein interactions were performed with co-immunoprecipitation, which demonstrated no interaction. These results have clearly shown that the NF-kB and AHR genes interact with HBX without involving CYP1A1 and HBX protein-protein interactions. The present study confirms that AHR and NF-kB interaction plays a role in the HBV mechanism mediated via HBX and coordinating the carcinogenic or inflammatory responses; still, the CYP1A1 gene has no effect on this interaction., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: This study was carried out to investigate the effect of autologous platelet-rich plasma (PRP) on intra-abdominal adhesion at the cesarean section incision line in the uterus., Material and Methods: As experimental animals 16 white New Zealand rabbits, 5-months-old, unmated, were used. Animals were divided into two groups the control group and PRP application group. In each group, a transverse incision was made to the uterus to mimic the cesarean section and sutured. Relaparotomy was performed 21 days after the first operation., Results: When the groups were evaluated in terms of inflammation, there was a significant difference between the two groups. When the groups were evaluated in terms of Mason's Trichrome staining and fibrosis, There was a significant difference between groups. When the groups were evaluated in terms of vascular endothelial growth factor-1, there was also a significant difference between the groups. In an experimental rabbit uterine horn adhesion model, PRP is effective in preventing post-operative adhesion formation., Conclusions: This result may guide clinical studies using autologous PRP to prevent post-operative adhesion formation after gynecological operations., (Copyright: © 2023 Permanyer.)

Objective: To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT)., Subjects: This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia., Methods: Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results., Results: Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max â€" 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute., Conclusions: This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.

Aim: To evaluate the retention rate of golimumab (GLM) in patients with rheumatoid arthritis (RA) and axial spondyloarthritis (ax-SpA). Materials & methods: Patients had received/were receiving GLM as their first or second biological drug for at least 3 months. We recorded demographic and clinical data, data on drug continuation and disease activity. Patients were classified as biologic-naive and biologic-experienced. Results: The study included 60 RA and 269 ax-SpA patients. At month 24, the retention rates were 67.2 and 57.1% (biologic-naive and biologic-experienced RA) and 74.8 and 80.4% (anti-TNF-naive and -experienced ax-SpA). No significant differences in retention were observed between the biologic-naive and -experienced groups for either disease. Conclusion: The results of this study confirm the effectiveness of GLM in the treatment of RA and axSpA with good retention rates at 2 years in a real-world setting in Turkey.

Transversus abdominis plane (TAP) block technique seems to offer one of the most efficient methods for a local pain control. Our aim is to demonstrate the effectiveness and safety of TAP block for post-operative pain control under laparoscopic vision in elderly patients during laparoscopic cholecystectomy. The patients aged more than 65 years old, who had cholecystectomy due to symptomatic cholelithiasis, were retrospectively evaluated. The patients that were operated under general anesthesia + laparoscopic TAP block and those who were operated only under only general anesthesia were compared according to their' age and gender, comorbidities, American Society of Anesthesiologists scores, visual analog scale (VAS) for pain and length of stay in the hospital. Median (±interquartile range) values of post-operative 24th-hour-VAS for pain was found consecutively 2 (±1-3) in TAP block + group and 3 (±2-5) in TAP block - group. The median post-operative 24th-hour-VAS value in overall patients was three. Patients' VAS values were higher in the TAP block - group with a statistically significant difference (p = 0.001). Furthermore, no statistically significant difference was found for other parameters in two groups. The laparoscopic-guided TAP block can easily be performed and has potential for lower visceral injury risk and shorter operational time. Efficacy, safety and other advantages (analgesic requirements, etc.) make it an ideal abdominal field block in elderly patients.

Cyclophosphamide (CP) has a range of adverse effects on liver tissue in humans and animals. Administering an antioxidant with CP might reduce such side effects. Therefore, we examined the role of vitamin E in CP-induced liver toxicity in rats. Male Wistar albino rats were divided into four groups, each of seven rats: control, CP only, CP + vitamin E, and vitamin E only groups. The rats were administered treatments intraperitoneally for 7 days. Then the serum malondialdehyde (MDA), alanine aminotransferase (ALT), aspartate transaminase (AST), and lactate dehydrogenase (LDH) levels were determined while the livers were removed, tissue was prepared using routine histological procedures, sections were stained using hematoxylin and eosin, and the terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) method was applied. Histopathologically, CP caused hydropic degeneration, necrosis, pleomorphism, and mitotic activity. The number of TUNEL-positive cells and the MDA and ALT levels were significantly higher in the CP group. The antioxidant effects of vitamin E significantly decreased the number of TUNEL-positive cells and the ALT and MDA levels, and normalized the liver histopathology. CP induces apoptosis, has toxic effects on liver tissue, and changes the histological structure. The administration of vitamin E prevented the liver tissue damage caused by CP., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Valproic acid (VPA), used for the treatment of epilepsy and bipolar disorder, regulates several signaling pathways in brain cells. The up-regulated gene 4 (URG4/URGCP) is a novel gene located on 7p13. URG4/URGCP stimulates cyclin D1 (CCND1) mRNA expression, and URG4/URGCP silencing diminishes CCND1 mRNA expression in HepG2 cells. This study was performed to investigate the anti-cancer mechanism of action of VPA by analyzing the expression of novel gene URG4/URGCP, CCND1, p21, p53, p65 (RelA), Bax, and Bcl-2 in SHSY5Y neuroblastoma (NB) cancer cells. Cytotoxic effects of VPA in SHSY5Y were noticed in time and dose dependent manner with the IC50 doses within the range of 0.5-10 mM. IC50 doses in the SHSY5Y were detected as 7.5 mM. Expression profiles were determined by semi quantitative RT-PCR and URG4/URGCP protein change by western blot analysis. Our results suggest that VPA induces cell cycle arrest in SHSY5Y due to the decrease in URG4/URGCP, CCND1 gene expression and the increase in p65. To conclude, VPA may be a prospective agent for the treatment of NB as a single agent or in combination with other drugs. Thus, more studies should be designed to find a safe dose with the best effects of VPA.

Retinoic acid (RA) plays important roles in development, growth, and differentiation by regulating the expression of its target genes. The pro-apoptotic Bax gene may form channels through oligomerization in the mitochondrial membrane and facilitate the cytosolic release of cytochrome c. The anti-apoptotic Bcl-2 gene can inhibit this process. Up-regulated gene 4/Upregulator of cell proliferation (URG4/URGCP) is a novel gene located on 7p13. URG4/URGCP also stimulates cyclin D1 (CCND1) mRNA expression, and RNAi-mediated URG4/URGCP silencing diminishes CCND1 mRNA expression in HepG2 cells. In this study, the effects of RA treatment on URG4/URGCP, CCND1, Bcl-2 and Bax gene expression changes in undifferentiated and differentiated SHSY5Y neuroblastoma cells was analyzed. SHSY5Y cells were cultured in the appropriate conditions. To induce differentiation, the cells were treated with 10 micromolar RA in the dark for 3-10 days. SHSY5Y cells possess small processes in an undifferentiated state, and after treatment with RA, the cells developed long neurites, resembling a neuronal phenotype. Total RNA was isolated with Tri-Reagent. Expression profiles of the target genes were determined by semi-quantitative RT-PCR. According to the results, Bcl-2 and CCND1 gene expression levels were increased, while URG4/URGCP and Bax gene expression was decreased in RA treated cells compared to the control cells. Our preliminary results suggest that RA may induce cell proliferation and escape apoptosis using a novel pathway by the URG4/URGCP gene. Further investigations are needed to clarify more direct transcriptional targets of RA signaling and the interaction of RA pathways with other pro-regenerative signals.

Background/aims: Thalassemia is one of the most common hereditary disorders in Turkey. The aim of this study was to determine the prevalence of the beta-thalassemia trait and abnormal hemoglobins in the province of Adıyaman in Turkey., Methods: The study included 3571 high school students of both sexes; aged 12-22 (mean 16.59 ± 1.34). After they received information about thalassemia, they were screened for beta-thalassemia and abnormal hemoglobin using complete blood count (CBC) and quantification of hemoglobin. Hemoglobin was fractionated using HPLC., Results: The beta-thalassemia trait was found in 38 students (1.06%), and abnormal hemoglobin in seven students (0.20%). Of the latter, four carried HbD Los Angeles, two HbS, and one HbE-Saskatoon., Conclusion: The prevalence of the beta-thalassemia trait and abnormal hemoglobin in the province of Adıyaman is low, compared to the rest of Turkey. Our results seem to reflect the heterogeneity of beta-thalassemia in the province of Adıyaman and may be of value for genetic counseling and premarital screening.

Objective: Medical students were included in 3-person interview panels selecting applicants for a 4-year medical programme for graduates and health professionals. We analysed student contributions to the interview panels., Methods: A total of 188 semi-structured interviews were carried out over 2 years. The scores of 17 student interviewers were compared with those of the other 2 members of the panels., Results: Students were positive about the interview process and their involvement. Overall interview scores did not differ between students and other interviewers. However, students gave lower scores overall and in a number of individual areas to those who had the highest consensus scores and were offered places on the programme. Students were more likely than other interviewers to be indecisive between 2 scores (25.2% versus 17.5%; P < 0.01)., Conclusions: Students can be integrated effectively into the interview process. However, they tend to be more reluctant to give high scores and less decisive about committing to a single score than more experienced interviewers. Students value the experience of participating in the selection process, especially when combined with an exploration of the literature related to selection procedures.

Objective: To compare the lipid-altering effects of hormone replacement therapy alone and in combination with HMG-CoA reductase inhibitor in postmenopausal women with hypercholesterolemia., Methods: This was a prospective randomized controlled trial with 3 parallel groups. The patients (n = 35) were randomly assigned to receive pravastatin 20 mg/day (n = 12); continuous combined hormone replacement therapy (0.625 mg conjugated estrogen/day combined with medroxyprogesterone 5 mg/day) (n = 12); continuous combined hormone replacement therapy plus pravastatin (n = 11) for 16 weeks., Results: Among patients treated with continuous combined hormone replacement therapy levels of total cholesterol (10.7%) and LDL cholesterol (12.6%) decreased significantly (p < 0.05), while levels of high density lipoprotein cholesterol (5%) and triglycerides (6.2%) increased insignificantly (p > 0.05). Patients in the pravastatin group achieved significant reductions of 18.8 and 21.4% in total cholesterol and low density lipoprotein cholesterol levels, respectively (p < 0.05). Among patients treated with a combination of continuous combined hormone replacement therapy plus pravastatin, levels of total cholesterol (20.5%) and low density lipoprotein cholesterol (23.8%) decreased the most, while levels of triglycerides (2.1%) decreased lower than the pravastatin-only group. The mean percentage of the differences between the baseline and treatment levels of the lipids and lipoproteins were not significant between the 3 study groups (p > 0.05)., Conclusion: No significant difference between hormone replacement therapy alone and in combination with HMG-CoA reductase inhibitor in the treatment of postmenopausal women with hypercholesterolemia was noted in this study. The combination of hormone replacement therapy not only does not adversely affect the lipid-lowering effect of pravastatin alone, but hormone replacement therapy also offers additional benefits in the treatment of hypoestrogenic hypercholesterolemia in postmenopausal women.