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OBJECTIVE: Cholesteatoma (CHO) developing secondary to chronic otitis media (COM) can spread rapidly and cause important health problems such as hearing loss. Therefore, the presence of CHO should be diagnosed promptly with high accuracy and then treated surgically. The aim of this study was to investigate the effectiveness of artificial intelligence applications (AIA) in documenting the presence of CHO based on computed tomography (CT) images. PATIENTS AND METHODS: The study was performed on CT images of 100 CHO, 100 non-cholesteatoma (N-CHO) COM, and 100 control patients. Two AIA models including Res- Net50 and MobileNetV2 were used for the classification of the images. RESULTS: Overall accuracy rate was 93.33% for the ResNet50 model and 86.67% for the MobilNetV2 model. Moreover, the diagnostic accuracy rates of these two models were 100% and 95% in the CHO group, 90% and 85% in the N-CHO group, and 90% and 80% in the control group, respectively. CONCLUSIONS: These results indicate that the use of AIA in the diagnosis of CHO will improve the diagnostic accuracy rates and will also help physicians in terms of reducing their workload and facilitating the selection of the correct treatment strategy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In 2019, the Coronavirus Disease 2019 (COVID-19) pandemic broke out, caused by the coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Reinfections can be observed with various respiratory viruses, including human coronaviruses. Moreover, they may result from weak or waning initial immune response, reinfection with another genotype/subtype, or the rapid antigenic changes in the virus. The aim of this study was to investigate the likelihood of reinfection in COVID-19 patients that had a positive qPCR test result at least 60 days after a negative test result in patients that were confirmed with COVID-19 on qPCR. MATERIALS AND METHODS: The quantitative polymerase chain reaction (qPCR) results of a total of 105,000 samples that had been obtained between April 1, 2020, and February 1, 2021, in two separate authorized laboratories were retrospectively analyzed. 22 samples from 11 patients included in the study, qPCR tests were repeated for each sample using the Rotorgene Q PCR system with Diagnovital SARS-CoV-2 (RTA Labs, Turkey) Real-Time PCR kits. Positive samples were screened for B.1.1.7 and E484K mutations using the qPCR method on the Rotorgene Q PCR system with Bio-Speedy SARS-CoV-2 Variant Plus kits (Bioeksen Technology, Turkey). RESULTS: The 105,000 individuals comprised 55,614 men and 49,386 women. In the qPCR test, 14,511 (13.82%) individuals were found to be positive for SARS-CoV-2. Of these, 11 (0.076%) patients were included in the study based on the inclusion criteria. Accordingly, the risk of reinfection was calculated as 0.076% (95% confidence interval [CI]: 0.056%-0.096%) and the incidence was 1.04 per 10,000 population (95% CI: 0.62-1.38 per 10,000). No patient was admitted to the intensive care unit or died during both episodes. Moreover, no B.1.1.7 or E484K mutation was detected in any patient. CONCLUSIONS: The high frequency of COVID-19 infection poses serious risks for the development of new variants and the currently used vaccines are likely to lose their efficacy against new variants. To reduce these risks and to be successful in the fight against the pandemic, we suggest compliance with personal protective measures as well as rapid and widespread application of vaccination not only in developed countries but also in the whole world and the modification of currently used vaccines in such a way to fight against newly emerged variants. [ABSTRACT FROM AUTHOR]

Hypericum perforatum (HP) contains valuable and beneficial bioactive compounds that have been used to treat or prevent several illnesses. Encapsulation technology offers protection of the active compounds and facilitates to expose of the biologically active compounds in a controlled mechanism. Microcapsulation of the hydroalcoholic gum arabic and maltodextrin have hot been used as wall materials in the encapsulation of HP extract. Therefore, the optimum microencapsulation parameters of Hypericum perforatum (HP) hydroalcoholic extract were determined using response surface methodology (RSM) for the evaluation of HP extract. Three levels of three independent variables were screened using the one-way ANOVA. Five responses were monitored, including total phenolic content (TPC), 2,2-Diphenyl-1-picrylhydrazyl (DPPH), carr index (CI), hausner ratio (HR), and solubility. Optimum drying conditions for Hypericum perforatum microcapsules (HPMs) were determined: 180 °C for inlet air temperature, 1.04/1 for ratio of maltodextrin to gum arabic (w/w), and 1.98/1 for coating to core material ratio (w/w). TPC, antioxidant activity, CI, HR, and solubility values were specified as 316.531 (mg/g GAE), 81.912%, 6.074, 1.066, and 35.017%, respectively, under the optimized conditions. The major compounds of Hypericum perforatum (hypericin and pseudohypericin) extract were determined as 4.19 μg/g microcapsule and 15.09 μg/g microcapsule, respectively. Scanning electron microscope (SEM) analysis revealed that the mean particle diameter of the HPMs was 20.36 µm. Based on these results, microencapsulation of HPMs by spray drying is a viable technique which protects the bioactive compounds of HP leaves, facilitating its application in the pharmaceutical, cosmetic, and food industries., (© 2024. The Author(s).)

Background: No study has investigated the impact of dual-tasking difficulties as a risk factor for unemployment in people with multiple sclerosis (pwMS). The aim was to examine the influence of dual-task performance on employment status and work difficulties and to identify the predictors of employment status in pwMS., Methods: Eighty-four pwMS, including 42 employed and 42 unemployed, participated in the study. Dual-task difficulties were assessed using the Dual-task Impact on Daily-living Activities-Questionnaire (DIDA-Q), while dual-task performance was evaluated through the 30-second Walk Test and Nine-Hole Peg Test, incorporating a cognitive task. Walking and cognitive function were also measured., Results: Employed pwMS had better scores in walking, cognitive function, single and dual-task performance than unemployed pwMS (p < .05). Lower scores in walking (odds ratio [OR] = 1.81, p < .001) and upper extremity-related (OR = 1.44, p = .019) dual-task performance and higher scores in the cognitive subscale of the DIDA-Q questionnaire (OR = 1.20, p = .037) were significantly associated with higher odds of being unemployed. Among employed pwMS, DIDA-Q subscales showed moderate-to-strong correlations with MSWSDQ-23 scores. The other variables showed weak-to-moderate correlations with subscale and total scores of MSWSDQ-23., Conclusion: Cognitive function, as opposed to motor function, has been found to be a significant predictor of unemployment in pwMS., (© 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Objective: Physiological fluorodeoxyglucose (FDG) uptake of spinal cord needs to be correctly recognized during evaluation of whole-body PET scans, especially for oncological cases. Our aim was to analyze physiological cord FDG uptake and its relation to gender, age, body weight, environmental temperature and time to imaging., Materials and Methods: PET scans of 254 patients in a single year, one patient for every working day were retrospectively selected. Temperature data were obtained from meteorology recordings. Maximum standard uptake value (SUVmax) of spinal cord at cervical and lower thoracic levels were noted. Spinal canal at L5 level, cerebellum and liver were used for normalization. Correlations with age, body weight, time to imaging and environmental temperature were analyzed., Results: Cervical SUV was higher than thoracic SUV (2.5-2.3). Cervical and lower thoracic SUV's were strongly correlated, highest when corrected with L5 level vertebral canal and liver (corr coeff 0.84 and 0.75) and lowest with cerebellum (corr coeff 0.4). Cervical spinal cord FDG uptake was higher for females than males (2.6 to 2.4). Temperature and age did not change spinal cord uptake. There were weak positive correlations with body weight (corr coeff 0.16 and 0.28, cervical and thoracic). There was weak negative correlation of cervical uptake with time to imaging (corr coeff -0.17)., Conclusion: Spinal cord FDG uptake at cervical and lower thoracic levels are strongly correlated. Females have slightly higher cervical SUV. Age and temperature does not change spinal cord FDG uptake in adults. Cord SUV's slightly increased with body weight.

Primary malignant melanoma occurs most often in the skin and much less frequently in the choroid layer of the eyes, in the leptomeninges, oral cavity, nasal mucosa, pharynx, esophagus, bronchus, under the nail and vaginal or anorectal mucosa. Primary melanoma of the gastrointestinal tract has been confirmed for lesions occurring in the esophagus, stomach, small bowel, and anorectum through several published reports, as these are the areas where melanocytes normally exist. The occurrence of primary malignant melanoma in the colon is relatively rare, because melanocytes are embryologically absent in the large bowel. Herein we report a patient whose colonic malignant melanoma was diagnosed and disseminated metastatic lesions were revealed with 18 F-FDG PET/CT scan. There were multiple nodular lesions showing increased 18 F-FDG uptake in both lungs. There was a soft tissue lesion with slightly increased 18 F-FDG uptake, which extended to the intraluminal region of the thoracic esophagus. Increased metabolic activity was detected in the asymmetric stomach wall thickening site and in a soft tissue lesion located on the gall bladder wall that was filling the lumen. Multiple hypodense/hyper-metabolic lesions were identified in the liver. Multiple hyper-metabolic polypoid soft tissue lesions were visualized in almost the entire colonic segments. Multiple hyper-metabolic peritoneal implants were noted in all abdominal quadrants. Increased 18 F-FDG uptake was detected at the right surrenal gland soft tissue lesion. There was a hyper-metabolic soft tissue lesion on the posterior wall of the rectum. Hyper-metabolic lytic lesions were seen at the thoracal and lumbar vertebrae, left scapula, left iliac bone, sacrum and left femur. There was no evidence of 18 F-FDG avid skin lesions in both attenuation corrected and non-corrected images.

Different concentrations of cherry laurel pulp (0, 5, 10, 15 and 20%) were used to produce tarhana samples. Volatile aromatic compounds and minor mineral content were investigated. Volatile aromatic compounds were analyzed by using GC-MS with SPME fiber and minor mineral values were evaluated with inductively coupled plasma optical emission spectrometer. The statistical analysis showed that addition of pulp affected volatile aromatic compounds and minor mineral content significantly. Thirty five volatile aromatic compounds were found in tarhana samples. The octanoic acid from acids, benzaldehyde (CAS) phenylmethanal from aldehydes, 6-methyl-5-hepten-2-one from ketones, octadecane (CAS) n -octadecane form terpenes, ethyl caprylate from esters and benzenemethanol (CAS) benzyl alcohol from alcohols had the highest percentage of volatile aromatic compounds. Tarhana samples were rich source of Mn, Cu and Fe content.

The objective of this research was to investigate the effects microbial transglutaminase (m-TGs) on the physicochemical, microbial and sensory properties of kefir produced by using mix cow and soymilk. Kefir batches were prepared using 0, 0.5, 1 and 1.5 Units m-TGs for per g of milk protein. Adding m-TGs to milk caused an increase in the pH and viscosity and caused a decrease in titratable acidity and syneresis in the kefir samples. Total bacteria, lactobacilli and streptococci counts decreased, while yeast counts increased in all the samples during storage. Alcohols and acids compounds have increased in all the samples except in the control samples, while carbonyl compounds have decreased in all the samples during storage (1-30 d). The differences in the percentage of alcohols, carbonyl compounds and acids in total volatiles on the 1st and the 30th d of storage were observed at 8.47-23.52%, 6.94-25.46% and 59.64-63.69%, respectively. The consumer evaluation of the kefir samples showed that greater levels of acceptability were found for samples which had been added 1.5 U m-TGs for per g of milk protein.

Background: The prognostic value of blood culture testing in the diagnosis of bacteremia is limited by contamination., Objectives: In this multicenter study, the aim was to evaluate the contamination rates of blood cultures as well as the parameters that affect the culture results., Materials and Methods: Sample collection practices and culture data obtained from 16 university/research hospitals were retrospectively evaluated. A total of 214,340 blood samples from 43,254 patients admitted to the centers in 2013 were included in this study. The blood culture results were evaluated based on the three phases of laboratory testing: the pre-analytic, the analytic, and the post-analytic phase., Results: Blood samples were obtained from the patients through either the peripheral venous route (64%) or an intravascular catheter (36%). Povidone-iodine (60%) or alcohol (40%) was applied to disinfect the skin. Of the 16 centers, 62.5% have no dedicated phlebotomy team, 68.7% employed a blood culture system, 86.7% conducted additional studies with pediatric bottles, and 43.7% with anaerobic bottles. One center maintained a blood culture quality control study. The average growth rate in the bottles of blood cultures during the defined period (1259 - 26,400/year) was 32.3%. Of the growing microorganisms, 67% were causative agents, while 33% were contaminants. The contamination rates of the centers ranged from 1% to 17%. The average growth time for the causative bacteria was 21.4 hours, while it was 36.3 hours for the contaminant bacteria. The most commonly isolated pathogens were Escherichia coli (22.45%) and coagulase-negative staphylococci (CoNS) (20.11%). Further, the most frequently identified contaminant bacteria were CoNS (44.04%)., Conclusions: The high contamination rates were remarkable in this study. We suggest that the hospitals' staff should be better trained in blood sample collection and processing. Sterile glove usage, alcohol usage for disinfection, the presence of a phlebotomy team, and quality control studies may all contribute to decreasing the contamination rates. Health policy makers should therefore provide the necessary financial support to obtain the required materials and equipment.

Introduction: Spondylodiscitis (SD) is an uncommon but important infection. The aim of this work was to study the risk factors, bacteriological features, clinical, laboratory and radiological findings of SD, and to shed light on the initial treatment., Methodology: A total of 107 patients who underwent treatment for SD were evaluated. The diagnosis of SD was defined by clinical findings, complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum tube agglutination (STA) test, Ziehl-Neelsen staining, culture, histopathology, and radiological methods such as magnetic resonance imaging (MRI) and computed tomography (CT) scans., Results: Of the 107 cases, ranging between 17 to 83 years of age, 64 (59.8%) were male. Twenty-seven (25.2%) patients had diabetes mellitus. Laboratory investigations revealed elevated CRP in 70 (65%) patients, elevated ESR in 65 (61%) patients, and elevated white blood cell (WBC) counts in 41 (38.3%) patients. Thirty-six (33.6%) patients were identified as having brucellar SD, and 5 (4.7%) patients were identified as having tuberculous SD. A total of 66 (61.6%) patients were determined to have pyogenic SD. The most frequently isolated microorganism was Staphylococcus aureus. Antibiotic therapy was given intravenously to all pyogenic SD patients., Conclusions: The incidence of SD has increased as a result of the higher life expectancy of older patients with chronic debilitating diseases and the increase of spinal surgical procedures. In patients with low back pain, SD should be considered as a diagnosis. For effective treatment, it is important to determine the etiology of the disease.

Objective: Immunosuppressive therapies, especially tumor necrosis factor-α inhibitors, are frequently used in treatment of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). These therapies can induce viral reactivation in concurrent hepatitis B virus (HBV)- or hepatitis C virus (HCV)-positive patients. On the other hand, the prevalence of HBV and HCV infections is not exactly known in RA and AS patients. The aim of this study was to investigate the prevalence of HBV and HCV infections in RA and AS patients., Material and Methods: A group of 1517 RA and 886 AS consecutive patients followed by six different rheumatology outpatient clinics of Turkey were recruited in this study. The prevalence of HBV surface antigen (HBsAg) and HCV antibody (anti-HCV) were retrospectively investigated., Results: The mean age was 49.0±13.2 years in RA and 37.3±10.5 years in AS patients. HBsAg prevalence was 35 (2.3%) in RA and 27 (3%) in AS patients. Anti-HCV prevalence was 17 (1.1%) and 10 (1.1%), respectively. In the RA group, both HBsAg and anti-HCV positive patients were older than negative ones (p<0.05), and the highest prevalence was found in those 60-69 years (p<0.05)., Conclusion: In previous national data, the prevalence of HBsAg has been reported as 3.99% and shown to increase with age. In this study we have found a lower HBV infection prevalence in both RA and AS patients according to Turkish national data. This result may explain by being younger age of our patients. In another conclusion, lower prevalence could be related to, joint complaints may less consulted to Rheumatologist in HBV positive.

Malaria is still a problem in the southeastern region of Turkey despite all the effort to eradicate the disease. The spread of malaria is by the transfer of agents by mosquitoes, transfusions of blood and blood products, organ transplantations from infected individuals and the use of contaminated injectors. The numerical load of parasites in infected donors may be very low, therefore no clinical symptoms may be observed and Plasmodium species may live in the body of donors for years. As the agents may live long in the body of donors, the blood from donors must be examined thoroughly for agents. The aim of this study was to determine whether malaria which is endemic in our region is transmitted by transfusion products. The blood from 1850 donors, who presented at the Dicle University Faculty of Medicine Blood Bank (Diyarbakir) in 2006, was examined by the optimal rapid malaria test and by Giemsa stained preparations. No pathogens were detected by any of these methods. In conclusion, the screening tests for malaria may be useful but not sufficiently sensi-tive for blood banks. In endemic regions; a more specific questionnaire and physical examination can be used to exclude blood donors who are at the risk of malaria.

In this study; we investigated the prevalence and distribution of malaria in the city of Diyarbakir, retrospectively. The investigation was carried out according to age, gender and areas of settlement between 1999 and 2004. The records were obtained from the Health Directorship of the Ministry of Health in Diyarbakir. A total of 22,062 malaria cases (11,643 male, 10,419 female) had been reported during a period of five years. Compared to previous years, the prevalence of malaria had significantly decreased. However; since the geographic conditions in Diyarbakir are suitable for the reproduction of Anopheles spp. and malaria is still endemic in Diyarbakir, the fight against malaria should be continued.

This prospective, blinded, placebo-controlled study was performed to compare the postoperative analgesic efficacy of low-dose intrathecal and epidural morphine with paraspinal muscle infiltration of bupivacaine in lumbar discectomy cases. Eighty ASA I-III adult patients undergoing elective surgery for lumbar disc disease were enrolled in the study. Patients were randomized to four groups by envelopes. Study groups were as follows: group 1 (n = 20), intrathecal morphine 0.1 mg; group 2 (n = 20), epidural morphine 2 mg; group 3 (n = 20), 30 mL of bupivacaine 0.25% paraspinal muscle infiltration; group 4 (n = 20), 30 mL of saline paraspinal muscle infiltration before wound closure. Recorded parameters were time to response to painful and verbal stimuli and postoperative pain assessed at 30 minutes and 2, 4, 6, 8, 12, and 24 hours by Visual Analog Scale (VAS) and Numeric Pain Scale (NPS). Hemodynamic data, sedation scores, and side effects were also recorded. Meperidine and naproxen sodium were used for postoperative analgesia. Follow-up was performed by a blinded investigator. Mean VAS scores were lower in groups 1 and 2 at 30 minutes (P < 0.05). Mean VAS score of group 2 was lower than that of group 4 at 4 hours postoperatively (P < 0.05). Mean NPS scores were lower in groups 1 and 2 at 2, 4, and 6 hours (P < 0.05) and in group 2 at 8 hours compared with the other groups. The number of patients requiring meperidine at early postoperative phase (0-6 hours) was less in groups 1 and 2 compared with groups 3 and 4 (P < 0.05). There were no statistically significant differences in the late postoperative analgesic requirements, after correction for multiple testing. In conclusion, low-dose intrathecal and epidural morphine provide lower postoperative pain scores and a reduction in early postoperative analgesic requirement with insignificant side effects compared with paraspinal bupivacaine or saline infiltration.

The objective of this study was to evaluate the correlation between serum hepatitis D -delta- virus (HDV) RNA detection and anti-HDV IgG and IgM antibodies, in the serodiagnosis of delta hepatitis. A total of 153 HBsAg positive sera were screened for the presence of anti-HBc IgM, anti-HDV IgG and anti-HDV IgM by commercial enzyme immunoassays and HDV-RNA by real time polymerase chain reaction (PCR). Of 153 sera, 86 (56.2%) were found positive for HDV antibodies. Although isolated anti-HDV IgG was present in 35 and isolated anti-HDV IgM was present in 11 patients, IgG and IgM were present concurrently in 40 additional patients. HDV-RNA was detected in 21.5% (33/153) of the patients. Four of the 33 HDV-RNA positive patients were positive only for anti-HDV IgG, 8 were positive only for anti-HDV IgM, and 19 were positive for both anti-HDV IgG and IgM antibodies. Twenty seven of 51 (53%) anti-HDV IgM positive patients were also found positive for HDV-RNA, while 27 of 33 (82%) HDV-RNA positive patients exhibited anti-HDV IgM positivity. Increased serum ALT levels were detected approximately in 85% (28/33) of viremic patients. As all of the HDV-RNA positive patients were found negative for anti-HBc IgM, superinfection with delta virus were considered. In conclusion, PCR is a sensitive and useful method for the detection of viremic patients as well as for the monitorization of antiviral therapy, anti-HDV IgM positivity together with increased ALT levels appear to be good markers for the prediction of hepatitis delta viremia, especially in the countries with limited economical sources as Turkey.

Objective: Suicide is defined as ending ones life with his own will. It is the most frequent reason of death in psychiatry and accepted as tragic since it can be the cause of young peoples deaths. In this study patients with recent suicide attempt were compared with major depression patients without suicide history and the control group by means of emotional and cognitive variables since suicide is an important complication of major depression and both have similar cognitive processes., Method: Thirty patients from each group were assessed by means of demographic variables, Beck depression inventory, UCLA loneliness scale, automatic thoughts scale, and suicide probability scale. Results were analyzed by SPSS for Windows., Results: Three groups were not statistically different by means of demographic variables except age and sex. Women were high risk group for major depression and suicide. The mean age of suicide group was significantly lower than major depression group. When analyzed by means of emotional and cognitive variables; the suicide group had high depressive symptomatology. Automatic thoughts scale scores were higher in the suicide group than the major depression group. Three groups did not differ by means of UCLA loneliness scores. When groups were compared by suicide probability scale; the major depression group and the suicide group did not differ in sub scales except hostility., Conclusion: Major depression groups high scores in hostility scale which may be the explanation of suicide; is one of the most important findings in this study