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Abstract Introduction Acute kidney injury (AKI) is linked to disease severity and prognosis in patients with coronavirus disease 2019 (COVID-19), and mortality increases even with milder stages. This study primarily investigated the effects of continuous renal replacement therapy (CRRT) timing on intensive care unit (ICU) mortality in patients with COVID-19 with acute respiratory distress syndrome (ARDS) and AKI. Secondary goals were secondary goals for the ICU, days without life support treatment, and change in post-CRRT day biomarker levels, the length of ICU and overall hospital stay. Methods In this retrospective study, patients with COVID-19 with ARDS and AKI were divided into CRRT initiated at AKI stages 1 and 2, early-CRRT (E-CRRT) and AKI stage 3, late-CRRT (L-CRRT) and followed until discharge or death. Results E-CRRT had 20 patients and L-CRRT had 18 patients. No association between CRRT timing and ICU mortality was detected (p = 0.724). Moreover, the timing was not associated with ICU, total hospital stay, or days without life support treatment. However, it was associated with D-dimer levels for both groups and ferritin and C-reactive protein (CRP) levels for E-CRRT. There were no associations for other markers, such as procalcitonin, troponin T, pro-brain natriuretic peptide (pro-BNP), interleukin-6, fibrinogen, or antithrombin III levels. Conclusions CRRT timing was not associated with ICU mortality, total hospital stay, or days without life support treatment in this cohort. For E-CRRT, ferritin and CRP levels, and for both groups, D-dimer levels, were associated with CRRT timing. Randomized controlled trials are needed to examine the effects of CRRT timing in patients with COVID-19 with ARDS and AKI.

ObjectivesThe aim of this study is to compare acute effects of consuming extra virgin coconut oil (EVCO) as a source of medium chain fatty acids and extra virgin olive oil (EVOO) as a source of long chain fatty acids in normal weight and obese subjects.DesignRandomised, crossover design.ParticipantsMetabolically healthy twenty male subjects (10 normal weight; 10 obese) aged 19-40 years.InterventionSubjects consumed breakfast meals containing skimmed milk, fat-free white cheese, bread and EVCO (25 g) or EVOO (25 g).Outcome measuresVisual analog scale evaluations, resting metabolic rate measurements and selected blood parameters analysis (glucose, triglyceride, insulin and plasma peptide YY) were performed before and after the test breakfast meals. In addition, energy intakes were evaluated by ad libitum lunch meal at 180 min.ResultsVisual analogue scale values of hunger and desire to eat decreased significantly after EVCO consumption than EVOO consumption in normal weight subjects at 180 min. There was an increase trend in plasma PYY at 30 and 180 min after EVCO breakfast compared to EVOO breakfast. Ad libitum energy intakes after EVCO and EVOO consumption in normal weight subjects were 924 ± 302; 845 ± 158 kcal (p = 0.272), respectively whereas in obese subjects were 859 ± 238; 994 ± 265 kcal (p = 0.069) respectively.ConclusionThe results of this study shows that consumption of EVCO compared to EVOO may have suppressive effect on hunger and desire to eat, may affect postprandial PYY levels differently and have no effect on postprandial energy expenditure.Trial registrationClinical Trials NCT04738929.

Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objective: This study aimed to investigate the physiological and anatomical factors influencing the flexor carpi radialis (FCR) H-reflex and to establish reference values for FCR H-reflex parameters in relation to these factors., Methods: The FCR H-reflexes, elicited by median nerve stimulation, were assessed in 80 healthy individuals both at rest and during isometric voluntary contraction (IVC). Multiple linear regression analyses were performed with H-reflex parameters as the dependent variables, while age, gender, height, arm length, and weight were included as independent variables., Results: The FCR H-reflex was recorded bilaterally in nearly all healthy individuals (76 out of 80) during IVC, while it could be obtained in only 35% (28 out of 80) of these individuals at rest. During IVC, the maximum H-reflex amplitude (Hmax) and its ratio to the maximum M-response amplitude (Hmax/Mmax ratio) were significantly increased ( p  < 0.001). However, there were no changes in H-reflex latency, latency difference, conduction velocity (HRCV), or amplitude ratio ( p  > 0.05). In both conditions, age and arm length were the most important factors affecting H-reflex latency ( p  < 0.001), while HRCV was influenced only by age ( p  < 0.01). Women exhibited shorter H-reflex latencies ( p  < 0.01), and both Hmax amplitude and Hmax/Mmax ratio were higher in women during IVC ( p  < 0.05). The H-reflex amplitude ratio during IVC showed a tendency to decrease with age ( p  < 0.05)., Conclusion: These findings suggest that FCR H-reflexes are more reliably elicited during IVC, and that both physiological and anatomical factors should be considered when assessing H-reflex abnormalities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflict of interest., (Copyright © 2024 Mercan and Kuruoğlu.)

Objective: To define the impact of obesity on inflammatory and oxidative disturbances in antipsychotic-treated schizophrenia patients., Methods: Several cytokines, inflammatory, metabolic, and oxidative status markers were evaluated in obese (n = 40) and non-obese (n = 40) antipsychotic-treated patients and compared with age-and BMI-matched controls (n = 80)., Results: Schizophrenia patients had higher leptin, TNF-α, adiponectin, visfatin, resistin, P-selectin, NPY, BDNF, CD40-L, MCP-1, and malondialdehyde, and lower IL-6, ghrelin, neopterin, and vitamin E levels compared to their respective controls (p < 0.001). Total oxidant status was higher in non-obese patients compared to controls (p < 0.001), total antioxidant capacity was higher in obese compared to non-obese patients (p < 0.01), but vitamin A and paraoxonase levels were not different. High sensitive-CRP levels were higher in obsese controls relative to non-obese controls (p < 0.05) and in obese patients relative to non-obese patients (p < 0.001). Fasting glucose, insulin, HbA1c, HOMA-IR, uric acid, total cholesterol, and triglyceride concentrations were higher in obese patients compared to non-obese patients. Insulin concentrations and HOMA-IR were also higher in obese controls than in non-obese controls., Conclusions: Our results suggest that inflammatory responses and oxidative stress develop independently from obesity in antipsychotic-treated schizophrenia patients. However, schizophrenia-induced obesity causes metabolic disturbances; thereby, obese schizophrenia patients are more liable to cardiovascular events and progress of metabolic syndrome than non-obese patients., (© 2024 John Wiley & Sons Ltd.)

Background: Fatigue is a common complaint among patients with myasthenia gravis (MG). In this study, we investigated the alterations in muscle morphology in patients with MG experiencing fatigue using quantitative electromyography (QEMG), and explored the relationship between electrophysiological findings and the severity of both fatigue and disease., Methods: We performed QEMG of the biceps brachii muscle using the peak ratio method and multi-motor unit potential (MUP) analysis across three groups: 18 MG patients with fatigue, 34 MG patients without fatigue, and 33 healthy subjects. Stimulated single-fiber EMG was performed on the frontalis muscle. The severity of perceived fatigue and disease was subsequently assessed using the quantitative myasthenia gravis (QMG) score, the MG-activities of daily living (MG-ADL) profile, self-reported fatigue questionnaires, and handgrip strength measurements., Results: The QEMG study revealed a reduced mean MUP duration and size index (SI), in addition to an increased peak ratio in patients with MG (p < 0.05), which tended to be more pronounced in those experiencing fatigue. Compared to healthy subjects, MG patients with fatigue displayed a myopathic pattern characterised by a high peak ratio, short duration, and small-amplitude MUPs, without any increase in the number of phases or small time intervals. The mean peak ratio was positively correlated with the QMG, MG-ADL, and Fatigue Impact Scale total and physical subscores (p < 0.05). Further, MG patients with fatigue exhibited reduced maximum grip strength, which was positively correlated with the mean MUP duration, amplitude, SI, and thickness, and negatively correlated with the mean peak ratio (p < 0.05). No significant differences were observed in the jitter or block measurements (p > 0.05)., Conclusions: The present study investigated electrophysiological findings that were not considered or theorised in prior studies on patients with MG experiencing fatigue. The results of this study suggest that myopathic changes may be a critical pathophysiological component underlying the fatigue associated with MG., Competing Interests: 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., (© 2024 Published by Elsevier Ltd.)

Background and Aims: This study aimed to identify the clinical characteristics and electrodiagnostic subtypes of Guillain-Barré syndrome (GBS) in Istanbul., Methods: Patients with GBS were prospectively recruited between April 2019 and March 2022 and two electrodiagnostic examinations were performed on each patient. The criteria of Ho et al., Hadden et al., Rajabally et al., and Uncini et al. were compared for the differentiation of demyelinating and axonal subtypes, and their relations with anti-ganglioside antibodies were analyzed., Results: One hundred seventy-seven patients were included, 69 before the coronavirus disease 2019 pandemic (April 2019-February 2020) and 108 during the pandemic (March 2020-March 2022), without substantial changes in monthly frequencies. As compared with the criteria of Uncini et al., demyelinating GBS subtype diagnosis was more frequent according to the Ho et al. and Hadden et al. criteria (95/162, 58.6% vs. 110/174, 63.2% and 121/174, 69.5%, respectively), and less frequent according to Rajabally et al.'s criteria (76/174, 43.7%). Fourteen patients' diagnoses made using Rajabally et al.'s criteria were shifted to the other subtype with the second electrodiagnostic examination. Of the 106 analyzed patients, 22 had immunoglobulin G anti-ganglioside antibodies (14 with the axonal subtype). They had less frequent sensory symptoms (54.5% vs. 83.1%, p = 0.009), a more frequent history of previous gastroenteritis (54.5% vs. 22.9%, p = 0.007), and a more severe disease as compared with those without antibodies., Interpretation: Serial electrodiagnostic examinations are more helpful for accurate subtype diagnosis of GBS because of the dynamic pathophysiology of the disease. We observed no significant increase in GBS frequency during the pandemic in this metropolis., (© 2024 Peripheral Nerve Society.)

Abstract: The long-term effects of coronavirus disease 2019 (COVID-19) infection are not fully known. In this study, we aimed to evaluate cognitive function and mood changes with 1-year follow-up in the elderly after COVID-19 disease. Ninety COVID-19 survivors and 90 healthy controls were included in the study between April 2022 and 2023. The patients were evaluated at the 1st, 6th, and 12th months for cognition, depression, and sleep quality. Cognitive function is assessed by the Montreal Cognitive Assessment (MoCA), sleep quality by the Pittsburgh Sleep Quality Index, and depression by the Yesavage Geriatric Depression Scale. COVID-19 survivors secured lower scores in certain domains of the MoCA in comparison with the controls at the first and sixth months. However, at the 12th month, no difference was observed in total MoCA ( p = 0.100), Yesavage Geriatric Depression Scale ( p = 0.503), and Pittsburgh Sleep Quality Index ( p = 0.907) between survivors and controls. Older patients who recovered from COVID-19 have lower cognitive function compared with controls up to 12 months. However, cognitive function scores were similar at the end of the first year except for memory scores., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: We aimed to evaluate and compare the clinical and electrophysiological features of post-COVID-19 Guillain-Barré syndrome (GBS) and non-COVID-19 GBS patients over the last five years., Methods: We retrospectively analyzed patients diagnosed with GBS between October 2016 and September 2021. They were divided into five groups according to the flu season and the COVID-19 pandemic. Groups 1-4 were identified as non-COVID-19 groups, whereas Group 5 constituted the post-COVID-19 group. At the sixth month the Hughes functional grading scale score (HFGSS) was noted. Clinical and electrophysiological findings were compared between the groups., Results: Fifty-nine GBS patients were enrolled in this study. Post-COVID-19 GBS patients had more facial diplegia than non-COVID-19 GBS patients. Except for facial diplegia, post-COVID-19 GBS patients did not differ from non-COVID-19 GBS patients regarding the need for mechanical ventilation, loss of ambulation, type of GBS, response to treatment, and patient outcomes. In 67% of post-COVID-19 GBS patients, HFGSS was ≤2. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common subtype in post-COVID-19 GBS patients. The 2018-2019 flu season saw more ambulation loss than other flu seasons. The 2017-2018 influenza season had the highest number of patients (39%)., Conclusion: The clinical and electrophysiological features of GBS may differ according to year, infectious etiology, and severity of seasonal viral infections. Post-COVID-19 GBS patients mostly had the AIDP subtype with frequent facial diplegia. The prognosis of post-COVID-19 GBS patients was good. The patients responded well to treatment with intravenous immunoglobulin and plasma exchange., Competing Interests: Conflict of Interest: The authors declared that there is no conflict of interest.., (Copyright: © 2023 Turkish Neuropsychiatric Society.)

Chronobiology, which studies biological rhythms and their impacts on health, presents a potential avenue for treating amyotrophic lateral sclerosis. Clock gene-related therapies, focusing on genes responsible for regulating biological rhythms, may hold promise in the treatment. Among these clock genes, nuclear receptor subfamily 1 Group D member 1 (NR1D1) plays a vital role in neurodegenerative diseases. In this particular study, it was aimed to investigate the potential of FDA-approved drugs commonly used in amyotrophic lateral sclerosis treatment and melatonin, a hormone known for its role in regulating sleep-wake cycles, as ligands for clock gene-related therapy. The ligands were subjected to molecular docking and molecular dynamics simulation methods against the NR1D1 clock gene. These results suggested that combining melatonin with FDA-approved medications commonly used in the treatment might yield positive outcomes. This study provides preliminary data and lays the groundwork for future investigations involving in vitro (laboratory-based) and in vivo (animal or human-based) research on chronotherapy. In summary, this research highlights the potential of clock gene-related therapy utilizing melatonin in conjunction with FDA-approved drugs for amyotrophic lateral sclerosis treatment, offering insights into novel treatment strategies. The findings underscore the need for further studies to explore the effectiveness of this hypothetical approach in experimental and clinical settings.

Objectives: Bruxism is a common oral behaviour. This study aimed to compare oral health-related quality of life, sleep quality, and oral health literacy in patients with and without possible sleep bruxism (SB) and awake bruxism (AB)., Materials and Methods: A cross-sectional study including 249 volunteers was conducted in a family medicine clinic of a tertiary hospital in Istanbul, Turkey. The American Sleep Medicine Association Bruxism Diagnostic Criteria, Pittsburgh Sleep Quality Index (PSQI), Oral Health-Related Quality of Life (OHRQoL) tool, Decay Missing Filled Total Teeth (DMFT) score, and Health Literacy Dental Scale-Short Form (HeLD-14) were assessed by face-to-face interviews. Data were examined using Kruskal-Wallis and Mann-Whitney U tests, Spearman correlation, and logistic regression analysis., Results: The presence of SB and AB was detected as 41.4% and 21.7%, respectively, among 91 males and 158 females, with a mean age of 36.64 ± 11.60 years. Sleep and awake bruxers had a lower oral health-related quality of life (odds ratio (OR): 0.816, 95% confidence interval (CI) = 0.770-0.864 and OR: 0.923, 95% CI = 0.956-0.982, respectively). Poor sleep quality was detected 1.28 times higher in sleep bruxism (OR: 1.277, 95% CI = 1.152-1.415) and 1.14 times higher in awake bruxism (OR: 1.141, 95% CI = 1.230-1.058). The DMFT score was found to be 1.13 times higher in SB (OR: 1.129, 95% CI = 1.043-1.223). A higher HeLD-14 score was associated with a lower DMFT score ( p < 0.001; r  = -0.240). The oral health literacy score was lower in AB and SB groups than in patients without bruxism, but it was not statistically significant ( p = 0.267, p = 0.376)., Conclusion: A lower oral health-related quality of life and poor sleep quality would be expected in the presence of SB or AB. However, patients may not be aware of it unless asked by a physician regardless of oral health literacy level., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Melike Mercan Başpınar et al.)

Introduction: Malnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies., Material and Method: In this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined., Results: Of the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% ( n  = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% ( n  = 533) of the patients achieved the target calorie intake, and 81.65% ( n  = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p  = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h ( p  = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week ( p  = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p  = 0.024)., Conclusion: Timely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Misirlioglu, Yildizdas, Ekinci, Ozgur Horoz, Tumgor, Yontem, Talay, Kangin, Tufan, Kesici, Yener, Kinik Kaya, Havan, Tunc, Akçay, Sevketoglu, Durak, Ozel Dogruoz, Ozcan, Perk, Duyu, Boyraz, Uysal Yazici, Ozturk, Çeleğen, Bukulmez, Kacmaz, Dinleyici, Dursun, Koker, Bayraktar, Talip Petmezci, Nabaliyeva, Agin, Hepduman, Akkuzu, Kendirli, Ozen, Topal, Ödek, Ozkale, Ozkale, Atay, Erdoğan, Konca, Yapici, Arslan, Besci, Yilmaz, Gumus, Oto, Dalkiran, Mercan, Çoban, Ipek, Gungor, Arslankoylu, Alakaya, Sari, Yucel and Yazar.)

Objective: Breast cancer (BC) is the most common cancer type in women and may be inherited, mostly in an autosomal dominant pattern. The clinical diagnosis of BC relies on the published diagnostic criteria, and analysis of two genes, BRCA1 and BRCA2 , which are strongly associated with BC, are included in these criteria. The aim of this study was to compare BC index cases with non-BC individuals in terms of genotype and diagnostic features to investigate the genotype/demographic information association., Materials and Methods: Mutational analyses for the BRCA1/BRCA2 genes was performed in 2475 individuals between 2013-2022 from collaborative centers across Turkey, of whom 1444 with BC were designated as index cases., Results: Overall, mutations were identified in 17% (421/2475), while the percentage of mutation carriers in cases of BC was similar, 16.6% (239/1444). BRCA1/BRCA2 gene mutations were detected in 17.8% (131/737) of familial cases and 12% (78/549) of sporadic cases. Mutations in BRCA1 were found in 4.9%, whereas 12% were in BRCA2 (p<0.05). Meta-analyses were performed to compare these results with other studies of Mediterranean-region populations., Conclusion: Patients with BRCA2 mutations were significantly more common than those with BRCA1 mutations. In sporadic cases, there was a lower proportion with BRCA1/BRCA2 variants, as expected, and these results were consistent with the data of Mediterranean-region populations. However, the present study, because of the large sample size, revealed more robust findings than previous studies. These findings may be helpful in facilitating the clinical management of BC for both familial and non-familial cases., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by the the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.)

Background: The diverse and complex presentations of COVID-19 continue to impact the world. Factors related to prognosis and mortality are still not fully illuminated., Objectives: We aimed to asses the relationship of N-terminal pro B-type natriuretic peptide (NT-proBNP) and main pulmonary artery diameter (MPAD) with COVID-19 prognosis and mortality., Methods: 152 COVID-19 patients over the age of 18, were included in the study. Thoracic CT, NT-proBNP values, laboratory and demographic data of these patients were obtained by retrospectively examining the patient files and scanning the results through the patient registry., Results: According to multivariate logistic regression (LR) analysis, high NT-proBNP level (OR=3.542; 95% CI=1.745-9.463; p=0.021) and MPAD/ascending aortic diameter (AAD) ratio>0.75 (OR=2.692; 95% CI=1.264-9.312; p=0.036) were determined as independent risk factors predicting mortality in COVID-19 patients. A significant positive correlation was observed between NT-proBNP level and MPA diameter (r=0.296, p<0.001). The cut-off value was measured as 27.5 mm for MPA diameter and 742 pg/ml for NT-proBNP., Conclusions: Accurate and effective interpretation of available radiological and laboratory data is essential to reveal the factors predicting prognosis and mortality in COVID-19. In this study,we evaluated that the thorax CTs and determined that the MPAD/AAD and NT-proBNP level were independent risk factors in predicting mortality., (© 2023 Tastemur M et al.)

Thrombotic and microangiopathic effects have been reported in COVID-19 patients. This study examined the contribution of the hereditary thrombophilia factors Prothrombin (FII) and Factor V Leiden (FVL) genotypes to the severity of COVID-19 disease and the development of thrombosis. This study investigated FII and FVL alleles in a cohort of 9508 patients (2606 male and 6902 female) with thrombophilia. It was observed that 930 of these patients had been infected by SARS-CoV-2 causing COVID-19. The demographic characteristics of the patients and their COVID-19 medical history were recorded. Detailed clinical manifestations were analyzed in a group of cases (n = 4092). This subgroup was age and gender-matched. FII and FVL frequency data of healthy populations without thrombophilia risk were obtained from Bursa Uludag University Medical Genetic Department's Exome Databank. The ratio of males (31.08%; 27.01%) and the mean age (36.85 ± 15.20; 33.89 ± 14.14) were higher among COVID-19 patients compared to non-COVID-19 patients. The prevalence of FVL and computerized tomography (CT) positivity in COVID-19 patients was statistically significant in the thrombotic subgroup (p < 0.05). FVL prevalence, CT positivity rate, history of thrombosis, and pulmonary thromboembolism complication were found to be higher in deceased COVID-19 patients (p < 0.05). Disease severity was mainly affected by FVL and not related to genotypes at the Prothrombin mutations. Overall, disease severity and development of thrombosis in COVID-19 are mainly affected by the variation within the FVL gene. Possible FVL mutation should be investigated in COVID-19 patients and appropriate treatment should be started earlier in FVL-positive patients., (© 2023 Wiley Periodicals LLC.)

Since the outbreak of the first SARS-CoV-2 epidemic in China, pharmacists have rapidly engaged and developed strategies for pharmaceutical care and supply. According to the guidelines of the International Pharmaceutical Federation (FIP), clinical pharmacists/hospital pharmacists, as members of care teams, play one of the most important roles in the pharmaceutical care of patients with COVID-19. During this pandemic, many immuno-enhancing adjuvant agents have become critical in addition to antivirals and vaccines in order to overcome the disease more easily. The liquid extract obtained from the Pelargonium sidoides plant is used for many indications such as colds, coughs, upper respiratory tract infections, sore throat, and acute bronchitis. The extract obtained from the roots of the plant has been observed to have antiviral and immunomodulatory activity. In addition to its anti-inflammatory and antioxidant effects, melatonin plays a role in suppressing the cytokine storm that can develop during COVID-19 infection. Knowing that the severity and duration of COVID-19 symptoms vary within 24 hours and/or in different time periods indicates that COVID-19 requires a chronotherapeutic approach. Our goal in the management of acute and long COVID is to synchronize the medication regimen with the patient's biological rhythm. This chapter provides a comprehensive review of the existing and emerging literature on the chronobiological use of Pelargonium sidoides and melatonin during acute and prolonged COVID-19 episodes., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Gastrointestinal mucositis is a common and dose-limiting side effect characterized by ulcerative lesions in the mucosa of the digestive tract in patients receiving anticancer drugs such as 5-fluorouracil (5-FU), a potent antineoplastic drug. Several protocols have reported the efficacy of therapeutic interventions to prevent this side effect, although complete success has not yet been achieved and mucositis remains one of the most serious complications associated with 5-FU therapy. Oxytocin, a well-known antistress agent, has been reported to have comparable effects to ranitidine. Previous studies have shown that oxytocin inhibits gastric acid secretion and the expression of proinflammatory cytokines in rats. If oxytocin can reduce stress-induced ulcers via antioxidant, antiapoptotic, and anti-inflammatory pathways, then it may have a dose-dependent effect on gastrointestinal mucositis caused by 5-FU., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Competing Interests: There are no conflicts of interest.

Therapeutic plasma exchange (TPE) can be applied as an effective therapeutic option in children with hematological, neurological, nephrological, and autoimmune/rheumatic disorders. We aimed to report our TPE experience in pediatric patients. In this article, we retrospectively reviewed the records of pediatric patients who underwent TPE between 2019 and 2021. A total of 128 TPE sessions were performed in 25 patients (13 males,12 females; mean age 59.6 ± 11.7 [3-198] months). The TPE indications were sepsis with/without multiorgan dysfunction syndrome in five patients, acute liver failure, hemolytic uremic syndrome caused by Shiga toxin, and autoimmune hemolytic anemia in three patients, respectively, multiple sclerosis, autoimmune encephalitis, and multisystem inflammatory syndrome in children (MIS-C) in two patients each, and myasthenia gravis crisis, meningococcemia, hemolytic uremic syndrome caused by coronavirus disease 2019, hemophagocytic lymphohistiocytosis, autoimmune encephalitis, and metabolic disease (fatty acid oxidation defect, liver failure) in one patient each. Based on our findings, we proposed that the American Society for Apheresis criteria should be updated according to newly described clinical conditions such as MIS-C., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

Background: Snake envenomations are a serious cause of mortality and morbidity in the world., Aims: This study was conducted to investigate snake bites in pediatric patients in Kahramanmaraş and to determine whether pro-brain natriuretic peptide (proBNP) has a prognostic value in these patients., Methods: Pediatric patients aged <18 years who presented to the pediatric emergency department with snakebites were reviewed retrospectively. The demographical, clinical, laboratory, treatments, and outcomes data were collected from their medical records. Stage 0 and 1 envenomation was considered as a non-serious complication and stage 2 and 3 envenomation was considered as a serious complication., Results: A total of 32 pediatric patients, six females and 26 males, between 2016 and 2021, were included in the study. The mean age was 12.52±3.28 years. There were seven patients without serious complications and 25 patients with serious complications. The best cutoff point for proBNP to predict serious complications was found to be ≥272.5 ng∙L -1 (sensitivity, 83.3%; specificity, 100%, p =0.011). We also detected complex regional pain syndrome in one of our patients., Conclusions: In this study, proBNP was shown to be predictive of a poor outcome of snakebites. Moreover, complex regional pain syndrome, which is rarely reported in the literature, should be kept in mind during the long-term follow-up of snakebites., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, İpek et al.)