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OBJECTIVE: Cytokines are involved in the inflammatory/anti-inflammatory balance and have been shown to play an important role in the course of COVID-19. This study aimed to evaluate the relationship of periostin, transforming growth factor-beta (TGF-ß), interleukin-18 (IL-18), and matrix metalloproteinase 7 (MMP-7) levels with clinical course and mortality in patients with early COVID-19 pneumonia. PATIENTS AND METHODS: A total of 150 hospitalized patients were diagnosed with COVID-19 between June and October 2021, and a control group of 30 healthy individuals were included in our study. The COVID-19 patients were divided into those who developed macrophage activation syndrome (MAS) in Group 1 and those who did not in Group 2. Serum periostin, MMP-7, TGF-ß, and IL-18 levels were measured from blood samples obtained at admission using Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: P eriostin, M MP-7, a nd I L-18 l evels were significantly higher in COVID-19 patients compared to the control group (p<0.001 for all). Periostin and MMP-7 levels were also significantly higher in Group 1 than in Group 2 (p<0.001 for both). Periostin, MMP-7, IL-18, and TGF-ß levels were significantly higher in non-surviving patients compared to survivors (p=0.04, p<0.001, p<0.001, and p<0.001, respectively). In the receiver operating characteristic (ROC) curve analysis, MMP-7 was found to have high sensitivity (90%) at a predictive value of 2.66 ng/mL. CONCLUSIONS: It is still not possible to predict which patients with early COVID-19 pneumonia will go on to develop MAS despite receiving standard treatment. The results of our study suggest that elevation of periostin and MMP-7 levels in the early period may predict the development of macrophage activation syndrome. [ABSTRACT FROM AUTHOR]

This paper considers the extra component of quality, which goes beyond the limits of government norms and standards, as well as general market requirements to the quality of products that are dictated by competition. It includes ethical aspects of quality, which are connected to companies' manifesting corporate social and ecological responsibility. We determine the influence of three factors - buyer sophistication, market competition freedom, and entrepreneurs' non - commercial initiatives - on the ethical aspects of quality in the concept of corporate social responsibility. The purpose of this research is to study the international experience and specifics of developed and developing countries in the selected factors' influence on the ethical aspects of quality of products. The authors determine the key factor (combination of factors), which determines the ethical aspects of quality in the concept of corporate social responsibility - separately for developed and developing countries. To study corporate social responsibility, we use the materials of the dataset "Social entrepreneurship in the world economy: from virtual scores to big data - 2020" (https://iscvolga.ru/dataset-social-predprinim). To study corporate ecological responsibility, we use the materials of the dataset "Corporate social responsibility, sustainable development and fight against climate change: imitation modelling and neural network analysis in regions of the world - 2020" (https://iscvolga.ru/dataset-climate-change). We determined that the change of the existing model of conducting entrepreneurial activities in the modern conditions creates challenges for economic companies; one of these challenges is the provision of quality of products based on the observation of ethical norms in the concept of corporate social responsibility of company employees.

This study was aimed to investigate the combined effect of flushing and hormonal treatment on reproductive aspects of local goats, 60 adult does were divided equally into two groups, the first was fed concentrate plus grazing commencing 3 weeks prior to mating and continue for 4 weeks post mating (flushed) F, whereas the 2nd group was raised on pasture only (P). All does were synchronized using impregnated with 40 mg medroxy acetate for 14 days. Following sponges withdrawn, the flushed and non- flushed does were then sub-divided in to four equal groups, the 1st flushed does were injected with 250 i.u hCG (T1), the 2nd only flushed (T2), the 3rd was only injected with hCG (T3) and the 4th was the control (T4). Results revealed that estrus response was significantly higher in T1 (100%), followed by T3 and T4 (86.66%) and T2 (80%). Fertility rate was significantly (P˂0.01) higher in T1 (80%) followed by T3 (73.33%), T4 (66.66%) and T2 (60.0%). Highest kidding rate (120.0%) and litter size (1.50) was noticed in T1, while the lowest kidding rate (86.66%) were found in T2 and T4. Insulin level was significantly higher in flushed does (6.04) compared to non-flushed does (2.81 uIU/ML).

To evaluate the effect of different hormonal treatments on reproductive performance of local goats, 60 adult does were synchronized by using sponges impregnated with 40 mg medroxy acetate (MAP) for 14 days. Following sponges withindrawn, the does were allocated randomly to four equal groups. The first group was served as control and intramuscularly injected with normal saline (T1). The does in group 2,3 and 4 were injected intramuscularly with 250 i.u hCG(T2) 400 i.u. eCG(T3) and 20 µg GnRH(T4), respectively. Results revealed that the highest estrus response was recorded in T2 (100%) followed by T4(93.3%), T1 (86.7%) and T3(73.3%). Fertility rate was significantly (p˂0.05) higher in T4 (93.3%) and the lowest was found in T3 (66.7%). A significantly higher kidding rate (146.7%) and litter size (1.69) was recorded in T2. While the lowest kidding rats and litter size was recorded in T4 and T3, respectively.

The present study was aimed to assess and determine the effects of pregnancy on some biochemical and haematological parameters. This experiment was conducted using 16 pregnant of known gestational period and 4 non-pregnant does raised at commercial farm. Results revealed a non-significant differences between pregnant and non-pregnant does for all studied traits. With the advances of pregnancy, it was noticed an increase (P

Objectives: This study, which uses a randomized controlled design, aimed to determine the effect of foot reflexology on stress, fatigue, and low back pain (LBP) in intensive care unit (ICU) nurses., Methods: The study was conducted with intensive care unit nurses at two hospitals in a city between September 2022 and April 2023. The study sample consisted of 42 nurses, 21 of whom had low back pain for at least 3 months and 21 of whom were controls. In the study, foot reflexology was applied to the intervention group for 20 minutes (10 minutes on each foot) once a week for 4 weeks. There was no intervention applied to the control group. Data were collected using the Personal Information Form, the Perceived Stress Scale (PSS), the Fatigue Severity Scale (FSS), and the Visual Analog Scale (VAS)., Findings: Based on the change in the mean scores of the scale in the intervention and control groups over time, a statistically significant decrease was found between the pre-test (before foot reflexology) and post-test mean scores of the LBP-VAS (from 6.33 to 2.24, respectively) and the Fatigue Severity Scale (from 4.81 to 3.60, respectively) in the intervention group. Although there was no statistically significant difference between the perceived stress scale pre-test and post-test scores, it was found that there was a decrease in favor of the intervention group., Conclusion: Foot reflexology appears to offer promise as an effective method for ICU nurses to reduce lower back pain and fatigue., 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 © 2024. Published by Elsevier Inc.)

Introduction: The gold standard treatment for obstructive sleep apnea syndrome (OSAS) is positive airway pressure therapy (PAP) treatments. PAP treatments reduce complications by reducing apnea and hypopnea attacks by creating airflow at a determined pressure. In our study, we aimed to examine the effect of treatment compliance on kidney and liver functions, apneahypopnea (AHI) index, and lipid profile of patients diagnosed with OSAS and started PAP treatment., Materials and Methods: Patients who were admitted to the sleep laboratory of our hospital between September 2022 and September 2023 and started PAP treatment after PSG were included in our study. Patients who were called for follow-up six months after the initiation of PAP treatment were divided into two groups according to their compliance with PAP treatment. Patients who used the device for at least four hours per night and more than 70% at night were grouped as PAP-compliant patients, while the other patients were grouped as non-PAP-compliant patients., Result: It was observed that uric acid, BUN, triglyceride, total cholesterol, ALT, GGT, ALP, and AHI levels of the patients who started PAP treatment decreased after six months (p= 0.001, 0.006, <0.001, 0.006, 0.01, <0.001, <0.001, <0.001 with). It was observed that HDL cholesterol levels increased (p≤ 0.001). It was observed that the change in uric acid, AHI, total cholesterol, and GGT levels in group 1 (n= 36) patients who were compliant with PAP treatment was statistically higher than in group 2 (n= 30) patients (p< 0.001, <0.03, <0.001, 0.008, respectively)., Conclusions: Uric acid, total cholesterol and GGT are biomarkers that may increase in OSAS due to intermittent hypoxia with the involvement of other systems. Since a decrease in these biomarkers can be observed in the early period depending on treatment compliance, these biomarkers can be used practically in the follow-up of treatment compliance and treatment efficacy.

Introduction: Pulmonary thromboembolism (PTE) is a life-threatening disease, with substantial treatment-related complications, difficult follow-up, treatment compliance, and high costs. This study aimed to assess treatment costs with various maintenance therapy regimens, complications, and patient adherence to treatment over a one-year follow-up period., Materials and Methods: This observational, prospective study included 142 patients with PTE who received maintenance anticoagulation therapy between November 2020 and March 2023. The patients were observed at three-month intervals for a year. Possible treatment-related complications, recurrence, mortality, and treatment costs were recorded., Result: Our results showed that there was no significant difference in bleeding risk based on the drugs used for initial or maintenance treatment. In maintenance therapy, low-molecular-weight heparin (LMWH), warfarin, and direct oral anticoagulant (DOAC) treatment regimens had similar treatment adherence and comparable efficacy and safety in terms of recurrence and bleeding (p> 0.05). Four patients (2.8%) were diagnosed with chronic thromboembolic disease. The one-year mortality rate was 24.6% (n= 35), of which 82.9% (n= 29) occurred within the first three months. Hospital mortality rates with the different maintenance therapies were 8.8% in the LMWH group, 5.7% in the warfarin group, and 3.2% in the DOAC group. The annual cost of using LMWH was higher than that of rivaroxaban, apixaban, and warfarin (p< 0.001) while there was no significant cost difference between DOACs and warfarin (p> 0.05)., Conclusions: In our study, the LMWH, warfarin, and DOAC treatment regimens had similar efficacy, safety, and patient compliance. In terms of cost, LMWH was the costliest while DOAC and warfarin were similar.

Background: Although pulmonary fibrosis secondary to COVID-19 infection is uncommon, it can lead to problems if not treated effectively in the early period. This study aimed to compare the effects of treatment with nintedanib and pirfenidone in patients with COVID-19-related fibrosis., Methods: Thirty patients who presented to the post-COVID outpatient clinic between May 2021 and April 2022 with a history of COVID-19 pneumonia and exhibited persistent cough, dyspnea, exertional dyspnea, and low oxygen saturation at least 12 weeks after diagnosis were included. The patients were randomized to receive off-label treatment with nintedanib or pirfenidone and were followed up for 12 weeks., Results: After 12 weeks of treatment, all pulmonary function test (PFT) parameters, 6MWT distance, and oxygen saturation were increased compared to baseline in both the pirfenidone group and nintedanib groups, while heart rate and radiological score levels were decreased ( p  < 0.05 for all). The changes in 6MWT distance and oxygen saturation were significantly greater in the nintedanib group than in the pirfenidone group ( p  = 0.02 and 0.005, respectively). Adverse drug effects were more frequent with nintedanib than pirfenidone, with the most common being diarrhea, nausea, and vomiting., Conclusion: In patients with interstitial fibrosis after COVID-19 pneumonia, both nintedanib and pirfenidone were observed to be effective in improving radiological score and PFT parameters. Nintedanib was more effective than pirfenidone in increasing exercise capacity and saturation values but caused more adverse drug effects., (© 2023 Elsevier España, S.L.U. All rights reserved.)

Background: Acute pulmonary thromboembolism (PTE) is an important cause of morbidity and mortality that can reduce quality of life due to long-term complications during and after treatment discontinuation., Objectives: The aim of this study was to evaluate patients for these complications before discontinuing treatment and determine the necessity of computed tomography pulmonary angiography (CTPA) imaging., Methods: This retrospective study included 116 patients over the age of 18 who received anticoagulant treatment for at least 3 months and presented for treatment discontinuation to the Atatürk University Research Hospital Chest Diseases Outpatient Clinic between January 2015 and September 2019., Results: CTPA performed at treatment discontinuation showed complete thrombus resolution with treatment in 73 patients (62.9%). High pulmonary artery obstruction index (PAOI) at diagnosis was statistically associated with findings of residual or chronic thrombus on CTPA at treatment discontinuation (p = 0.001). In the differentiation of patients with residual/chronic thrombus and those with thrombus resolution, D-dimer at a cut-off value of 474 µg/L had 60% sensitivity and 70% specificity. At a cut-off value of 35.5 mmHg, mean pulmonary artery pressure on echocardiography had sensitivity and specificity of 72% and 77%, respectively. At a cut-off of 23.75, PAOI had sensitivity and specificity of 93% and 69%, respectively., Conclusion: In addition to physical examination findings, D-dimer and echocardiography were guiding parameters in the evaluation of treatment discontinuation and thrombus resolution in patients presenting to the outpatient clinic for discontinuation of treatment for acute PTE. PAOI at diagnosis may be another important guiding parameter in addition to these examinations., Competing Interests: Declaration of Competing Interest None declared. The authors received no financial support for the research and/or authorship of this article. The authors declare that they have no conflict of interest to the publication of this article., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The inflammatory balance is an important factor in the clinical course of COVID-19 (SARS-CoV-2) infection, which has affected over 300 million people globally since its appearance in December 2019. This study aimed to evaluate the correlation between exhaled nitric oxide (FeNO) level and parenchymal involvement in COVID-19. The study included 106 patients with the delta variant of COVID-19 identified by real-time PCR as well as 40 healthy control groups between October 2021 and March 2022. The patients were analyzed in three groups: moderate COVID-19 (group 1), severe COVID-19 without macrophage activation syndrome (MAS) (group 2), and severe COVID-19 with MAS (group 3). FeNO and CT scores were significantly higher in groups 2 and 3 at admission and discharge compared to group 1 (p = 0.001 for all). In addition, CT score at admission and CT score and FeNO level at discharge were higher in group 3 than in group 2 (p = 0.001 for all). It was found that the FeNO levels were higher in Groups 2 and 3 than in the control group (p = 0.001) during the admission. FeNO and CT scores showed strong positive correlation at admission and discharge (r = 0.917, p = 0.001; r = 0.790, p = 0.001). In receiver operating characteristic curve analysis for prediction of MAS, FeNO at a cut-off of 10.5 ppb had 66% sensitivity and 71% specificity. COVID-19 causes more severe lung involvement than other viral lower respiratory tract infections, leading to the frequent use of chest CT in these patients. FeNO assessment is a practical and noninvasive method that may be useful in evaluating for parenchymal infiltration in the diagnosis and follow-up of COVID-19 patients., (© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)

In addition to the highly variable clinical presentation of acute COVID-19 infection, it can also cause various postacute signs and symptoms. This study aimed to evaluate patients with postacute COVID-19 over 12 weeks of follow-up. The study included 151 patients who were diagnosed with COVID-19 by real-time polymerase chain reaction of a nasopharyngeal swab 1 month earlier, had radiologic findings consistent with COVID-19 pneumonia, and presented to the post-COVID-19 outpatient clinic between May and August 2021. The patients were divided into three groups based on COVID-19 severity: nonsevere pneumonia (Group 1), severe pneumonia (Group 2), and severe pneumonia requiring intensive care (Group 3). Evaluation of laboratory parameters at 4 and 12 weeks showed that Group 3 had a higher lactose dehydrogenase (LDH) level and a lower mean platelet volume than the other groups at both time points (p = 0.001 for all). Group 3 also had lower percent predicted forced vital capacity (FVC%), percent predicted forced expiration volume in 1 s (FEV1%), and percent predicted diffusion capacity of the lungs for carbon monoxide divided by alveolar volume (DLCO/VA%) compared to Groups 1 and 2 at Week 4 (p = 0.001, 0.004, 0.001, respectively) and compared to Group 1 at 12 weeks (p = 0.002, 0.03, 0.001, respectively). Patients with persistent dyspnea at 12 weeks had significantly lower FEV1%, FVC%, DLCO/VA%, and saturation levels in room air and significantly higher LDH, pro-BNP, D-dimer, and heart rate compared to those without dyspnea (p = 0.001 for all). Although the lungs are most commonly affected after COVID-19 infection, vascular and endothelial damage also causes multisystem involvement. Our study indicates that laboratory values, radiological signs, and pulmonary functional capacity improved in most patients after 12 weeks of follow-up., (© 2022 Wiley Periodicals LLC.)