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Background: Heart failure (HF) due to myocarditis might not respond in the same way to standard therapy as HF due to other aetiologies. The aim of this study was to investigate the value of endomyocardial biopsies (EMB) for clinical decision-making and its relation to the outcome of paediatric patients with myocarditis. Methods: Clinical and EMB data of children with myocarditis collected for the MYKKE-registry between 2013 and 2020 from 23 centres were analysed. EMB studies included histology, immunohistology, and molecular pathology. The occurrence of major adverse cardiac events (MACE) including mechanical circulatory support (MCS), heart transplantation, and/or death was defined as a combined endpoint. Results: Myocarditis was diagnosed in 209/260 patients: 64% healing/chronic lymphocytic myocarditis, 23% acute lymphocytic myocarditis (AM), 14% healed myocarditis, no giant cell myocarditis. The median age was 12.8 (1.4-15.9) years. Time from symptom-onset to EMB was 11.0 (4.0-29.0) days. Children with AM and high amounts of mononuclear cell infiltrates were significantly younger with signs of HF compared to those with healing/chronic or healed myocarditis. Myocardial viral DNA/RNA detection had no significant effect on outcome. The worst event-free survival was seen in patients with healing/chronic myocarditis (24%), followed by acute (31%) and healed myocarditis (58%, p=0.294). A weaning rate of 64% from MCS was found in AM. Conclusions: EMB provides important information on the type and stage of myocardial inflammation and supports further decision-making. Children with fulminant clinical presentation, high amounts of mononuclear cell infiltrates or healing/chronic inflammation and young age have the highest risk for MACE.

It is known that the service life of oilfield machines and mechanisms is to a certain extent determined by the operability of friction units, the operation of which, as a rule, occurs under severe conditions (heavy loads, abrasive aqueous medium, etc.). It is also known that the determining parameters in the units of machines and mechanisms (lubricated with water) with polymer elements are specific load, sliding speed and relative clearance. In the field, these factors affect the coefficient of friction together, therefore, the study of their influence [µ = f (p, ʋ, ψ)] on the coefficient of friction is possible only with the use of mathematical modeling. We have studied the nature of the joint influence of the main operating parameters on the performance of the ison thermoplastic elastomer plain bearings. Keywords: Operation, polymer elements, field conditions, bearings, sliding speed.

Background This study aimed to measure the levels of anxiety and burnout among healthcare workers, including attending physicians, residents, and nurses in intensive care units during the coronavirus disease 2019 (COVID-19) pandemic. Methods This is a cross-sectional survey analysis of healthcare workers in our institution. Data were collected on demographic variables, COVID-19 symptoms and test, disease status, anxiety level (assessed by the Beck Anxiety Inventory), and burnout level (measured by the Maslach Burnout Inventory). Subscales of the burnout inventory were evaluated separately. Results A total of 104 participants completed the survey. Attending physicians, residents, and nurses constituted 25%, 33.7%, and 41.3% of the cohort, respectively. In comparison to untested participants, those tested for COVID-19 had a lower mean age (p = 0.02), higher emotional exhaustion and depersonalization scores (p = 0.001, 0.004, respectively), and lower personal accomplishment scores (p = 0.004). Furthermore, moderate to severe anxiety was observed more frequently in tested participants than untested ones (p = 0.022). Moderate or severe anxiety was seen in 23.1% of the attending physicians, 54.3% of the residents, and 48.8% of the nurses (p = 0.038). Emotional exhaustion, personal accomplishment, and depersonalization scores differed depending on the position of the healthcare workers (p = 0.034, 0.001, 0.004, respectively). Conclusion This study revealed higher levels of anxiety and burnout in younger healthcare workers and those tested for COVID-19, which mainly included residents and nurses. The reasons for these observations should be further investigated to protect their mental health.

Shoulder pain is a common symptom for non-traumatic shoulder pathologies and affects 4.7-66.7% of entire population. Even with the latest technological advantages, palpation still is a cost and time efficient tool to evaluate the shoulder pathologies. Our aim was to investigate and compare palpation findings in different shoulder pathologies.We used first assessments of impingement syndrome (IS) (n = 205), rotator cuff tear (RCT) (n = 185) and frozen shoulder (FS) (n = 210) patients who received treatment between 2010 and 2019 years. Two experienced physiotherapists palpated predefined points: long head of biceps brachii, pectoralis minor, lateral intermuscular septum, proximal tendons of extensor group. These points categorized into "proximal", "mid-proximal", "mid-distal", "distal", "irregular". We also grouped patients by their BMIs.We found RCT patients had higher BMI than IS and FS patients (p 0.001, p = 0.001); more tender intermuscular septum points and night pain than IS patients (p = 0.001, p = 0.003) and more extensor group proximal tendon points than IS and FS patients (p 0.001, p = 0.001). "No tenderness" group had lesser resting pain than distal group (p 0.001) and lesser activity and night pain than middle-proximal, middle-distal, and distal groups (all ps 0.002). Distal group had higher night pain than middle-proximal group (p = 0.003). Morbidly obese patients had higher night pain than normal and overweight patients (p = 0.003 and p = 0.009).Tender point distribution varies depending on the pathology with biceps brachii being the most common. RCT patients had higher night pain related to more distal tender points. Patients with higher night pain had increased tenderness in septum intermuscular and extensor muscles' proximal tendons.

Background: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer.Method: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%).Results: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC.Conclusion: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer.

Kabuki syndrome (KS) is a disease characterized by distinctive facial features, skeletal anomalies and delay in neuromotor development. KS 1 is an autosomal dominant condition caused by mutations in the KMT2D gene, whereas KS 2 is an X-linked disorder caused by mutations in the KDM6A gene. In the majority of KS patients who present with hypoglycemia, KDM6A is the defective gene. A 9-month old girl was admitted to our emergency department due to a seizure. On physical examination, hypotonia, mild facial dysmorphism, brachydactyly of the 5th finger, prominent finger pads and pansystolic murmur were detected. A fasting glucose tolerance test was performed the next day due to her history of hypoglycemia, but she had convulsions at the fifth hour of the test. Her serum glucose was 24 mg/dL, insulin 1.94 mIU/L, C-peptide 0.94 ng/mL, growth hormone 11 ng/mL, anti-insulin antibody 4.2 IU/mL, cortisol 19.8 μg/dL, and adrenocorticotropic hormone 9.3 pg/mL. A diagnosis of hyperinsulinemic hypoglycemia was considered. Given the abnormalities, genetic analysis for congenital hyperinsulinism, including the genes causing KS was performed. A heterozygous frameshift mutation (c.2579del, p.Leu860Argfs*70) was detected in the KMT2D gene. Epilepsy and other neurological symptoms may be seen in KS patients and in some of these the neurological symptoms are the result of hypoglycemia. In such cases, the detection and prevention of hypoglycemia can help prevent the progression of neurological symptoms. We suggest considering the diagnosis of KS for patients with hypoglycemia and dysmorphic features, even if the patient does not manifest all features of KS.

Objective: Cholecystectomy materials are frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria. Material and Method:14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined. Results: A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered. Conclusion: In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.

To determine the structure and morphology of corneal endothelial cell layer in patients with acute anterior uveitis. Thirty-four eyes of 34 acute anterior uveitis patients and 34 eyes of 34 healthy subjects were included. Mean cell density, coefficient of variation, maximum cell area, minimum cell area, average cell area and hexagonality ratio values were evaluated by non-contact specular microscopy. Parameters recorded in both groups were compared. The mean maximum cell area was 1054,44 ± 251,14 µm2, minimum cell area was 152.29 ± 53.65 µm2 and average cell area was 386.91 ± 41.73 µm2 in acute anterior uveitis group and the mean maximum cell area was 1057.65 ± 261.23 µm2, minimum cell area was 147.26 ± 20.45 µm2 and average cell area was 383.53 ± 43.12 µm2 in the control group. There were no significant differences between the two groups in terms of maximum, minimum and average cell area (respectively, p = 0.080, p = 0.72, p = 0.62, p = 0.67). The mean cell density was 2607.74 ± 277.63 cells/ µm2 in acute anterior uveitis group and 2669.35 ± 265.22 cells/µm2 in the control group. (p = 0.358). In acute anterior uveitis group the mean coefficient of variation was 31.68 ± 8.16, hexagonality ratio was 63.85 ± 11.14 and mean central corneal thickness was 571.47 ± 55.99 µm; in control group the mean coefficient of variation was 25.29 ± 3.00, mean hexagonality ratio was 72.6 ± 4.80% and mean central corneal thickness was 534.82 ± 33.84 µm. Statistically significant differences were seen between the two groups (respectively, P = 0,00, P = 0,00, P = 0.02). The mean central corneal thickness and coefficient of variation values were found higher, and the hexagonality ratio was found lower in acute anterior uveitis group. Our findings suggest that intraocular inflammation in anterior chamber negatively affects the endothelial function in patients with acute anterior uveitis.

Objective: We routinely calculate the pulmonary to systemic (Qp/Qs) ratio to avoid missing any left-to-right shunts in patients with precapillary pulmonary hypertension (PH). However, the pulmonary artery oxygen saturation (SpaO(2)) was lower than the mixed venous oxygen saturation (SmvO(2)) calculated using the formula; hence, the Qp/Qs ratio was calculated as less than "1" in some patients despite the absence of any detectable shunt. We hypothesized that this observation might have prognostic significance; however, to the best of our knowledge, it has not been investigated yet. Therefore, we aimed to examine the prognostic value of the Qp/Qs ratio in precapillary PH without left-to-right shunts.

Purpose: There are not many questionnaires that have proven validity and reliability in evaluating the level of physical activity in older patients with chronic obstructive pulmonary disease (COPD). In clinical and scientific studies, it is important to quickly determine the physical activity level of patients in terms of time management. The aim of the study was to examine the validity of the rapid assessment of physical activity (RAPA) questionnaire in older patients with COPD. Methods: A total of 105 older patients with COPD surveyed the short form of the International Physical Activity Questionnaire (IPAQ-SF) and after 2 weeks RAPA questionnaire as well. The IPAQ-SF was accepted as the gold standard for physical activity assessment in COPD. Furthermore, patients were assessed for a 6-min walking test (6MWT) and perceived dyspnea (with modified medical research dyspnea scale (mMRC)). Correlation coefficients (r) was used for the relationship between RAPA and IPAQ-SF. Results: There were significant positive correlations between RAPA and IPAQ-SF total score (r = 0.968, p< 0.001), 6MWT (r = 0.626, p< 0.001), in addition to significant negative correlation between the RAPA and mMRC scores (r = -0.454, p< 0.001). The RAPA showed good sensitivity (87.5%) and a specificity (100%) value. Positive and negative predictive values of the RAPA were 100% and 96.4% respectively. Conclusion: This study showed the RAPA was an easy-to-use, valid, and reliable questionnaire to measure physical activity levels in older patients with COPD.

Objectives The aim of this study was to evaluate the resilience of girls with central precocious puberty (CPP) during treatment with a gonadotropin-releasing hormone agonist (GnRHa) and compare these results with their healthy peers. Methods The Connor–Davidson Resilience Scale (CD-RISC) is a self-report scale used to quantify resilience, which is divided into seven subgroups (hardiness, coping, flexibility, purpose, optimism, regulation of emotion and cognition (REC), and self-efficacy). Fifty-one girls with CPP receiving GnRHa treatment and 51 healthy controls were involved in the study. Anthropometric measurements were evaluated and CD-RISC was performed at least six months after the initiation of GnRHa treatment. Results There was no statistically significant difference between the anthropometric evaluations of girls with CPP and the control group. Similarly, the total score and subgroup scores of patients with CPP and the control group showed no statistically significant difference. In the correlation analysis, there was a weak negative correlation between height and flexibility (r=−0.314 p=0.025), height SDS and flexibility (r=−0.254 p=0.092), height SDS, and purpose (r=−0.285 p=0.058). Also, there was a weak negative correlation between REC and weight (r=−0.435 p=0.003), REC and weight SDS (r=−0.461 p=0.002), REC and height (r=−0.269 p=0.077), REC and height SDS (r=−0.322 p=0.033), REC and BMI (r=−0.289 p=0.058), and REC and BMI SDS (r=−0.353 p=0.019). Conclusions The resilience of girls with CPP treated with GnRHa was found to be similar to their healthy peers. The early diagnosis of the disease and adequate treatment may decrease the discrepancy of somatic changes between girls with CPP and their peers, which may help them to overcome the stress of CPP and long-term treatment.

Background: The most common cause of increased morbidity and death throughout the chronic kidney disease (CKD) process is atherosclerosis, which advances quickly and is linked to cardiovascular diseases (CVDs). Sclerostin levels in CKD and CVDs have a complicated connection. Objective: We examined the relationship between serum sclerostin levels and atherosclerosis in patients with stage 3, 4, or 5 CKD who were not receiving hemodialysis treatment. Patients and Methods: A total of 125 patients aged >18 years with CKD stage 3, stage 4 and non-dialysis stage 5 were enrolled in the study. Patients with obesity, uncontrolled hypertension, coronary artery disease, with active cancer or liver disease, malignant hematologic disorders, acute renal failure, acute or chronic infections, were excluded. As for the control group; healthy volunteers without any known illness, regular drug use, smoking, alcohol use, and obesity were recruited. Results: Study population was diagnosed as 39.2% with diabetes mellitus and 91.2% of patients with arterial hypertension. 54% of the patients were female. There was a positive correlation between serum sclerostin levels and carotid intima media thickness (CIMT). A negative correlation was found between serum sclerostin levels and GFR and 25-OH vitamin D levels. Sclerostin levels were found to be significantly higher in the group with high CIMT levels. There was no difference in terms of other parameters. Conclusion: Sclerostin levels were significantly higher in patients with abnormal CIMT independent of GFR, calcium, phosphorus and PTH values. This finding suggests that the serum sclerotin level can be used as a CVD marker in patients with CKD.

Splanchnic venous thrombosis is a rare type of venous thromboembolism, and its actual incidence is still unknown. Splenic infarction develops due to splenic vein (SV) thrombosis. Patients with COVID-19 may be exposed to a risk of thrombotic events, and the system affected at the highest level by coagulopathy is the respiratory system. The case presented here is splenic infarction that developed because of SV thrombosis, which is a rare form of venous thromboembolism.

Background In the near future, sensitive, rapid and economical detection of food allergens will remain a hardship to the health promotion of the community. Biogenic Amines (BAs) are a type of food allergens, and due to the trace level and complexity of BAs, improvement of professional and cost-effective detection techniques has become particularly demanding. Since vegetables, canned and fresh fish, beverages, and fermented foods have high concentrations of BAs and are mainly consumed, the advancement of specific and finely tuned methods for quick diagnosis of BAs are exceedingly urgent. Scope and approach In this review, enzyme-based biosensors for BAs detection in foods with different transducers such as chemiluminescent, surface-enhanced raman scattering biosensors electrochemical, and fluorescence biosensors are presented. Nanozymes-based detection of BAs in foods are also discussed with recent applications. Moreover, the latest advances of BAs detection by enzyme-based biosensors and nanozyme-based methods are further tabulated. Key findings and conclusion Among modern diagnostic techniques, biosensors are economical, simple, and precise instruments for BAs detection. In the future, studying novel biosensors such as multifunctional nanocomposite biosensors will satisfy the demand for the enhancement of food safety and cost-effective nanozyme-based methods for BAs detection.

OBJECTIVE: This study aimed to focus on non-COVID-19 patients during the process when all physicians focused on COVID-19 patients. Patients with pulmonary diseases in the COVID-19 pandemic period were analyzed. MATERIAL AND METHODS: Non-COVID-19 cases who were hospitalized in the pulmonology clinic, outpatients, and patients who applied to the non-COVID-19 emergency service and requested a pulmonology consultation in the period from March 16, 2020 to May 15, 2020 and in the same period of the previous year (i.e., from March 16, 2019 to May 15, 2019) were included in this study. RESULTS: In the pandemic period, it was found that there was an 84% decrease in outpatient admissions, a 43% decrease in inpatients, and a 75% decrease in emergency services. During the pandemic period, in outpatient setting, male and younger case admissions increased, admissions with chronic obstructive pulmonary disease (COPD), and interstitial lung diseases decreased, whereas the frequency of admission to asthma, pneumonia, and pulmonary thromboembolism increased. In the period of the pandemic, patients with asthma, COPD, and lung cancer were less hospitalized, whereas patients with pulmonary thromboembolism, pneumonia, and pleural effusion were hospitalized more. In non-COVID-19 patient treatments during the pandemic period, usage of a metered dose inhaler increased. CONCLUSION: During the COVID-19 pandemic, non-COVID pulmonary pathologies decreased significantly, and there was a change in the profile of the patients. From now on, to be prepared for pandemic and similar extraordinary situations, to organize hospitals for the epidemic, to determine health institutions to which nonepidemic patients can apply, to make necessary plans in order not to neglect the nonepidemic patients, and to develop digital health service methods, especially telemedicine, would be appropriate.

This study aimed to determine the prevalence of infantile functional gastrointestinal disorders (FGIDs) based on Rome IV diagnostic criteria, and to determine the associated patient demographic and nutritional characteristics. A total of 2383 infants aged 1-12 months which were evaluated by 28 general pediatricians and pediatric gastroenterologists on the same day at nine tertiary care hospitals around Istanbul, Turkey, between November 2017 and March 2018, were included in the study. Patients included consulted the pediatric outpatient clinics because of any complaints, but not for vaccines and/or routine well child follow-ups as this is not part of the activities in the tertiary care hospitals. The patients were diagnosed with FGIDs based on Rome IV diagnostic criteria. The patients were divided into a FGID group and non-FGID group, and anthropometric measurements, physical examination findings, nutritional status, risk factors, and symptoms related to FGIDs were evaluated using questionnaires. Among the 2383 infants included, 837 (35.1%) had ≥1 FGIDs, of which 260 (31%) had already presented to hospital with symptoms of FGIDs and 577 (69%) presented to hospital with other symptoms, but were diagnosed with FGIDs by a pediatrician. Infant colic (19.2%), infant regurgitation (13.4%), and infant dyschezia (9.8%) were the most common FGIDs. One FGID was present in 76%, and ≥2 FGIDs were diagnosed in 24%. The frequency of early supplementary feeding was higher in the infants in the FGID group aged ≤6 months than in the non-FGID group (P = 0.039).Conclusion: FGIDs occur quite common in infants. Since early diversification was associated with the presence of FGIDs, nutritional guidance and intervention should be part of the first-line treatment. Only 31% of the infants diagnosed with a FGID were presented because of symptoms indicating a FGID. What is Known: • The functional gastrointestinal disorders (FGIDs) are a very common disorder and affect almost half of all infants. • In infants, the frequency of FGIDs increases with mistakes made in feeding. When FGIDs are diagnosed in infants, nutritional support should be the first-line treatment. What is New: • This study shows that only a third of children presented to hospital because of the symptoms of FGIDs, but pediatricians were able to make the diagnosis in suspected infants after appropriate evaluation. • The early starting of complementary feeding (

Amaç: Bu araştırmada, hemşirelik öğrencilerinin eğitim ile ilgili algıladıkları stres ve internet bağımlılığı arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Tanımlayıcı tipteki bu araştırma Mart-Nisan 2016 tarihleri arasında 258 öğrenci ile gerçekleştirilmiştir. Verilerin toplanması için Hemşirelik Eğitimi Stres Ölçeği ve İnternet Bağımlılığı Ölçeği kullanılmıştır. Verilerin istatistiksel değerlendirilmesinde Mann-Whitney U, Kruskal Wallis Test ve Spearman Korelasyon Testi kullanılmıştır. Bulgular: Öğrencilerin yaş ortalaması 20.87±0.95’dir. Öğrencilerin Hemşirelik Eğitimi Stres Ölçeği toplam puan ortalaması 55.17±15.01 olup, ölçeğin alt boyutları olan uygulama stresi puan ortalaması 27.64±7.83, akademik stres puan ortalaması 27.51±7.82 ve İnternet Bağımlılığı Ölçeği puan ortalaması 34.29±12.26’dır. Uygulama ve akademik stres alt boyutları arasında pozitif yönde anlamlı bir korelasyon olduğu, Hemşirelik Eğitimi Stres Ölçeği ile İnternet Bağımlılığı Ölçeği arasında ilişki olmadığı saptanmıştır. Sonuç: Araştırmadan elde edilen sonuçlar, öğrencilerin hemşirelik eğitimi ile ilgili orta derecede stres algıladıkları, internet bağımlılığının olmadığı, bağımlılık riskinin ise düşük oranda olduğunu göstermektedir.

Amaç: Bu çalışmada kriptosporidiozis ile doğal olarak enfekte olmuş neonatal buzağıların tedavisinde gamitromisinin klinik etkinliğinin belirlenmesi amaç- lanmıştır. Gereç ve Yöntem: 5-20 günlük 20 diyareli neonatal buzağı oluşturdu. Kriptosporidiozis tanısı mikroskopik inceleme ve ELISA testi ile konuldu. Dışkıda gram başına 4 x 104 ile 15 x 106 arasında kriptosporidium ookisti görülen buzağılar çalışmaya dahil edildi. Hemogram ve kan gazları tedavinin başlangı- cında ve tedaviden sonra ölçüldü. Buzağılara subkutan olarak tek doz 6 mg/ kg dozunda gamitromisin uygulandı. İlacın etkinliği, 5. güne kadar ishalin durumu, ookist saçılımı ve vücut durumunun değerlendirilmesi ile takip edildi. Bulgular: Beşinci günde, altı tane buzağı dışkısında ookist saptanmazken, 11 buzağı dışkısında ookist sayısı önemli oranda azaldı. Tedavinin başlangıcında ve tedaviden sonra kan değerlerinde istatistiksel olarak belirgin fark (p, Aim: The purpose of this study was to investigate the clinical efficacy of gamithromycin in the treatment of naturally infected neonatal calves with cryptosporidiosis. Materials and Methods: 5-20 days old 20 diarrheic neonatal calves were used as material in this study. Diagnosis of cryptosporidiosis was made by microscopic examination and ELISA test. Calves shedding Cryptosporidium oocysts between 4 x 104 and 15 x 106 per gram in feces were included in the study. Hemogram and blood gases were measured at the beginning of the treatment and after the treatment. A single dose of 6 mg/kg body weight of gamithromycin was administered subcutaneously. Drug efficacy was assessed by evaluating the existence of diarrhea, oocyst shedding and body condition from day 1 to 5. Results: On 5th day, the medicated 6 calves had no oocysts, and number of oocysts in feces had been decreased in 11 calves on 5th day. Statistically significant difference (p

SUMMARY OBJECTIVE: To evaluate the effect of the treatment of obstructive sleep apnea syndrome on overactive bladder symptoms. METHODS: All patients who applied to the outpatient clinic with complaints of snoring and apnea were evaluated by polysomnography between years 2017 and 2019. obstructive sleep apnea syndrome severity was evaluated according to the apnea-hypopnea-index. All patients were filled with questionnaire form as overactive bladder symptoms score, international quality of life, international consultation on incontinence questionnaire short-form, and 3-day bladder diary before polysomnography and three months after continuous positive airway pressure therapy and surgical treatment. RESULTS: A total of 125 patients, 34 (27.2%) patients with mild obstructive sleep apnea syndrome, 27 (21.6%) patients with moderate obstructive sleep apnea syndrome, and 64 (51.2) patients with severe obstructive sleep apnea syndrome were included in the study. The prevalence of overactive bladder symptoms in three obstructive sleep apnea syndrome groups were 67.6, 53.8, and 48.4%, respectively, and there was no statistical difference between the groups (p=0.190). obstructive sleep apnea syndrome treatment such as surgical treatment or continuous positive airway pressure therapy was applied to 45.5% (31 patients) patients with obstructive sleep apnea syndrome and overactive bladder. Three months after treatment, the overactive bladder symptoms score significantly decreased from 16.1±7.9–12.80±9.82, international quality of life was significantly increased from 105.0±23.2–110.4±22.2, and incontinence questionnaire short-form decreased from 11.9±4.0–10.4±5.6 (p=0.009, p=0.023, and p=0.248, respectively). There was a significant decrease between before and after treatment in terms of mean day-time frequency and mean urgency episodes of patients (p=0.007, p=0.002). CONCLUSIONS: Both surgery and continuous positive airway pressure treatment of obstructive sleep apnea syndrome improved overactive bladder symptoms, overactive bladder symptoms score, international quality of life, day-time frequency, and urgency episodes.

Sevinc, Cuneyd ( isu author) Karadeniz, Tahir ( isu author) The aim of the study was to determine different variables that may be predictive for prolonged lymporrhoea and duration of lymphatic drainage. Two hundred and three patients who underwent radical cystectomy (RC) and pelvic lymph node dissection (PLND) were enrolled in this study. Lymphorrhoea was defined as the total amount of lymph drained by the drains until their removal. Duration of drainage was defined as the days until the removal of the last drains. Parameters that might be related to lymphorrhoea and duration of drainage including age, body mass index (BMI), removed lymph nodes, hemoglobin level (gr/dl), estimated blood loss (ml) (EBL), platelet count (PLN), hospital stay (HS) and lymph node status were reviewed retrospectively. Statistical analyses were performed to determine the association between lymphorrhoea with probable predictors for these variables. The mean number of removed lymph nodes was 28.52 (16-58). The mean amount of lymphorrhoea and the duration of drainage were 1504 ml (300-5850) and 10.10 days (2-27), respectively. Multivariate analyses revealed that the mean amount of lymphorrhoea rises gradually as EBL, patients age, negative lymph nodes and lymphadenectomy extension increases (P

γ-Al2O3 was synthesized by the Sol–gel method, Ni (NO3)2 was placed in the pores by the impregnation method, and Ni-γ-Al2O3 was obtained by pyrolysis in a hydrogen stream in a CVD device. By the method of chemical vapors phase deposition (CVD) on Ni-Al2O3 catalytic converter with decomposition of methane in the natural gas produced carbon nanotubes (CNT) (Chunduri et al. in Mater Express 4(3):235–241, 2014; Zhou et al. in Appl Catal B 208:44–59, 2017). The catalytic activity of the catalysts in methane decomposition was examined from 650 °C to 900 °C by the method of chemical vapors phase deposition (CVD), the yield of CNTs tends to increase with the growth at the ratio of natural gas supply to hydrogen. The specific surface increases with an increase of nickel content and can reach 265.5 m2/g for a sample of 2% Ni-A12O3 at 850 °C. Growth at the temperature of methane decomposition leads to reduction in its specific surface. It has been established that the use of the Ni-Cu/γ-Al2O3 catalytic system, in which copper acts as a stabilizing additive, makes it possible to double the maximum yield of the carbon product during the decomposition of natural gas.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammation. Many cells and mediators have been found to be involved in the progression of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the association of the NLR and PLR with treatment options, length of hospital stay, and mortality of patients with COPD exacerbation in this study. MATERIALS AND METHODS: We retrospectively collected the data of COPD patients who were hospitalized with the diagnosis of COPD exacerbation. Demographic data, NLR, PLR, number of exacerbations in the last year, length of hospital stay, and deceased patients were evaluated. Correlations between NLR and PLR with length of hospital stay and treatment options were analyzed. NLR and PLR values were compared between deceased and survived patients. RESULTS: One hundred and nineteen patients were included in the study. The mean age of patients was 68.74 ± 9.2 years, and the mean length of hospital stay was 19.5 ± 13.5 days. The median NLR and PLR values were 3.7 (minimum–maximum: 1–10.8) and 109 (minimum–maximum: 7.4–890), respectively. NLR values were found to be higher in patients who required systemic steroid or invasive mechanical ventilation (IMV) (P = 0.001, P = 0.017). The cutoff value of NLR was 2.65 with 73.8% sensitivity and 54.9% specificity (area under the curve [AUC]: 0.675, P = 0.001) for systemic steroid requirement, and the cutoff value of NLR for IMV requirement was 4.19 with 77.8% sensitivity and 70.4% specificity (AUC: 0.741, P = 0.017). However, PLR values were not related with systemic steroid or IMV. CONCLUSION: NLR seems to be a superior prognostic inflammatory marker than PLR in COPD exacerbation for predicting treatment options.

The users can contribute to geographic information through platforms such as Wikimapia and OpenStreetMap. They can also generate data by themselves with their applications in cyber worlds like Google Earth. This study is primarily designed to be a guide regarding Volunteered Geographical Information (VGI) and to evaluate the geometric accuracy of data collected from volunteers on application. The main purpose of this study is to present basic information about Volunteered Geographical Information (VGI), why users are tending to use VGI, the accuracy of the data entered by the user, to examine the examples of use in various fields, to learn about geographic information systems and to compare this phenomenon and also by developing a VGI application to examine the similarity between the actual data and the data collected from volunteer users. A mobile and web-based application have been developed to collect traffic accident data from volunteer users. The geometric accuracy analysis was performed by comparing the data collected with this application with the data obtained from the General Directorate of Security.

Aim of the work: To evaluate the red blood cell distribution width (RDW) values in psoriatic arthritis (PsA) patients and to study the relationship between these values and disease activation. Patients and methods: Forty seven patients with PsA and 56 age- and sex matched healthy controls were included in this study. Laboratory test results of both groups were retrospectively collected from medical records; these included levels for white blood cell count, hemoglobin, platelet, RDW, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Disease activity score (DAS28) was used to evaluate disease activity. Results: The study comprised 47 PsA patients (32 females and 15 males) (F:M 2.1:1) with a mean age of 39.2 ± 9.9 (20–54) years and mean disease duration was 3.3 ± 1.94 (1–8) years. 39 (83%) patients were receiving monotherapy, 8 (17%) were receiving combined therapy. The RDW values were significantly higher when comparing active disease period (16 ± 3.9) of PsA patients versus inactive disease period (14.2 ± 1.04) and controls (14.03 ± 1.2) (p

Objectives Malnutrition has been shown to be associated with survival in a variety of diseases. Our aim is to evaluate the prognostic value of objective nutritional indexes indicating malnutrition, in patients underwent endovascular aortic replacement. Methods We retrospectively evaluated 149 consecutive patients who underwent technically successful endovascular aortic replacement operation between October 2010 and August 2019. Objective nutritional indexes, prognostic nutritional index, geriatric nutritional risk index and controlling nutritional status, scores were calculated using the preoperative data. Optimal cut-off values were obtained by receiver operating characteristic analysis. According to the cut-off values, we investigated the relationship between indexes and the long-term all-cause mortality. Results During mean 48.0 ± 30.3 months follow-up duration, in 47 of patients (31.5%), all-cause mortality were documented. In mortality group, prognostic nutritional index (42.8 ± 7.1 vs 51.3 ± 5.2, p Conclusions Malnutrition is associated with significant increase in postoperative long-term mortality in endovascular aortic replacement patients. Preoperatively calculated objective nutritional indexes especially prognostic nutritional index can be used as an important prognostic tool.

We report the case of a 16-year-old female with a huge mass (40 × 30 × 40 cm) on the left ovary, causing mild bilateral hydronephrosis. Ultrasonography and computed tomography allowed us to diagnose this condition and showed an associated uretero-hydronephrosis. A unilateral salpingo-oophorectomy was performed on the left ovary, and final pathology revealed a mature cystic teratoma. The patient did not experience any problems in the follow-up six months later, and her hydronephrotic appearance disappeared.

Canine parvoviral enteritis (PVE) is one of the most common diseases in young dogs. A range of diseases and inflammatory conditions can cause endothelial glycocalyx (eGCX) disruption, therefore, this study aimed to determine the presence of eGCX damage in dogs with PVE using serum biomarkers of eGCX, and to evaluate their prognostic importance among survivor and non-survivor dogs. Twenty dogs diagnosed with PVE and 10 healthy dogs of both sexes, mixed-breed, and under 6 months of age were included in the study. Clinical examination, blood gas analysis, and complete blood cell counts of the dogs were performed. To detect the eGCX injury, serum endothelial cell-specific molecule-1 (ESM-1), syndecan-1 (SDC-1), angiopoietin-2 (Ang-2), and heparan sulfate (HS) levels were measured. Results showed that at the time of admission serum levels of ESM-1 were higher in dogs with PVE compared to that of the healthy dogs. Dogs with PVE were further assigned into two groups: survivors (n:10) and non-survivors (n:10). The ESM-1 had high sensitivity and specificity to differentiate between survivor and non-survivor dogs with values of 100% and 67%, respectively, with at an optimum cut-off point of ≥460 pg/mL. We concluded that higher levels of ESM-1 in dogs with PVE may indicate eGCX injury when compared to healthy dogs. Also, the high levels of serum ESM-1 in non-survivor dogs suggest that serum ESM-1 may carry some prognostic usefulness for predicting mortality in dogs with PVE.

Lung transplantation is a life-saving treatment for patients with end-stage lung disease. Although the number of lung transplants has increased over the years, the number of available donor lungs has not increased at the same rate, leading to the death of transplant candidates on waiting lists. In this paper, we presented our initial experience with the use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation. Between December 2016 and August 2018, we retrospectively reviewed the use of ECMO as a bridge to lung transplantation. Thirteen patients underwent preparative ECMO for bridging to lung transplantation, and seven patients successfully underwent bridging to lung transplantation. The average age of the patients was 45.7 years (range, 19-62 years). The ECMO support period lasted 3-55 days (mean, 18.7 days; median, 13 days). In seven patients, bridging to lung transplantation was performed successfully. The mean age of patients was 49.8 years (range 42-62). Bridging time was 3-55 days (mean, 19 days; median, 13 days). Two patients died in the early postoperative period. Five patients survived until discharge from the hospital. One-year survival was achieved in four patients. ECMO can be used safely for a long time to meet the physiological needs of critically ill patients. The use of ECMO as a bridge to lung transplantation is an acceptable treatment option to reduce the number of deaths on the waiting list. Despite the successful results achieved, this approach still involves risks and complications.

OBJECTIVES: Adenoid tissue is important in local immune response and epithelial barrier dysfunction of this tissue may contribute to allergies. The aim of this study was to evaluate the relationship between the status of cross-epithelial barrier elements in adenoid tissue lymphoepithelium and inhalant allergen sensitization. MATERIALS AND METHODS: Children aged 5–15 years, who underwent adenotonsillectomy, participated in this study. All subjects underwent skin prick testing with environmental inhalant allergens. Occludin, ZO1, e-cadherin, β-catenin, desmoglein, desmoplakin, and connexon-43 were stained immunohistochemically in the adenoid tissues obtained and scored by H-score. RESULTS: We enrolled 76 children, 14 among whom were sensitized to environmental allergens. Among the zonula occludens proteins, median H-scores for occludin, claudin, and ZO-1 were significantly lower in the atopic compared to the nonatopic group respectively (p

Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by frequent attacks and chronic inflammation. Subclinical inflammation continues during the attack-free period. Omentin is an anti-inflammatory adipokine, which plays important roles in the adjustments of glucose metabolism, cardiovascular homeostasis and atherosclerosis. The aim is to investigate the omentin levels in FMF patients and to assess the association with markers of subclinical inflammation in FMF patients such as serum amyloid A (SAA), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).This cross-sectional study included 54 consecutive adult FMF patients (27 male, 27 female) and 28 healthy individuals (16 male, 12 female). The FMF patients were separated into 3 groups: (1) attack-free group, (2) active-attack group and (3) colchicine-resistant group. Serum omentin levels were compared between the FMF patients and the healthy control group.A significant difference was determined between the FMF patients and healthy control subjects in terms of omentin levels (108.05 (19.97-343.22) vs. 199.5 (42.98-339.41) p 0.05). SAA values were significantly higher in the FMF patients compared with the healthy control group. When the FMF patients were examined as separate groups, serum omentin values were lower in the colchicine-resistant group than in the groups without resistance (76.64 (19.77-224.33) vs. 186.47 (28.41-343.21) p = 0.006).FMF patients with colchicine resistance are associated with decreased omentin concentrations, probably mediated by inflammation-driven mechanisms. Key Points • Omentin is a type of adipokine which has an anti-inflammatory effect by inhibiting the inflammatory cytokine network. • Decreased omentin levels are associated with increased obesity, insulin resistance and comorbidities. • We report that omentin levels fluctuate in various diseases. In addition, we have focused on the levels of omentin in patients with FMF, as it may act as a biomarker for colchicine resistance.

Many years of experience in the operation of oilfield equipment during underground well repair shows that ensuring the reliability and durability of the pumping units used is one of the main elements of the process chain, largely determined by the quality and performance characteristics of the friction units of the hydraulic parts of the pumps. It is known that high-pressure oilfield pumps used in the repair of oil and gas wells carry out various technological works, including cementing, hydraulic fracturing, acid treatment, washing sand plugs and other washing and squeezing operations. Parts of the hydraulic parts of the pumps are subjected to abrasive, corrosion-mechanical and corrosion-abrasive wear, which often leads to sudden failures, fraught with emergencies, additional costs and loss of time for unscheduled repairs. The article considers the possibility of increasing the reliability of plunger oilfield pumps due to the correct removal of the material of the sealing collars and improving the assembly scheme. It is also proposed to use the diffusion monotonic distribution as a model of failure to evaluate the reliability function of the selected best compression scheme. Since this distribution model is a more flexible function that better aligns qualified data, compared to the well-known two-parameter strict probability models. The results of the work have theoretical and practical prerequisites for assessing the reliability of field pumping units and may be useful for specialists working in this field

This paper uses a complex structure of factors of exposure to international shocks for the analysis of regional and inter‐regional effects of a variety of financial shocks across Organization for Economic Co‐operation and Development (OECD) economies. Those factors (trade, finance, migration and others) are incorporated in a coherent and comparable scheme which, based on observed data, describes pair‐wise, directionally asymmetric exposures to foreign economies in the sample. Through a global vector auto‐regressive setting, a systemic approach characterizes our modelling by the means of which several standardized shocks are simulated varying the region of origin to compare their effects and spillovers. In the depicted map of risks, the shocks are of particular relevance to both wholesale and retail credit markets, stock and commodities markets and also for the management of monetary and fiscal policies in open economies. The diversity of responses between OECD regions is useful to understand the asymmetric impacts and degrees of relative vulnerability towards disturbances in international markets. A subset of Eurozone countries, for example, consistently shows significant sensitivity to foreign shocks. Other Eurozone countries experience a lower degree of imported volatility while Asia‐Pacific appears to be more resilient to shocks in OECD regions. In turn, the significance of the impacts of shocks in the North American Free Trade Agreement region is large enough for them to be close representations of global shocks.

Background Celiac disease (CD) is an autoimmune disease characterized by malabsorption. Serologic testing for CD consists of Ig A type of antitissue transglutaminase (tTG), antiendomysium (EMA). These tests are helpful in monitoring adherence to the gluten-free diet (GFD). Natural killer (NK) cell count alterations have been reported in various diseases, such as cancer, Crohn’s disease, malnutrition, and autoimmune disorders. Objective To compare peripheral blood NK cell counts in children with celiac disease (CD) to healthy controls. The second aim was to analyze for possible correlations between NK cells (CD3-/CD16+, CD56+) and tissue transglutaminase (tTG)-IgA and tTG-IgG, as well as endomysial antibody EMA-IgA indicating gluten sensitivity. Methods Fifty children with CD were compared to 48 healthy children as controls, with similar age and sex distribution. Peripheral blood NK cell counts were measured by flow cytometry. Results The median (P25-P75) ages of the 50 celiac patients (23 male; 46%) and 48 controls (21 male; 44%) were 10 (2-17) years and 9 (3-17) years, respectively. Mean follow-up duration was 3 years, ranging from 1-10 years. All CD patients had positive tTG-IgA and EMA-IgA tests while it was negative in all (100 %) control patients. The absolute number of circulating CD16+ NK cells (259.52 vs. 1404.36 μ/L) and CD56+ NK cells (366.24 vs. 2440.46 μ/L) were significantly lower in the celiac group than the control group (P0.05 for both). Correlation analysis between the absolute number of circulating NK cells and tTG-IgA, tTG-IgG, and EMA-IgA levels in CD patients revealed no significant relationships (P>0.05 for all). Conclusions Peripheral blood NK cell count were significantly lower in celiac patients than controls, hence, decreased NK cell counts may be an abnormal feature seen in autoimmune diseases. NK cell count in celiac patients had no significant correlations to tTG-IgA, tTG-IgG, or EMA-IgA levels. Therefore, NK cell count may be inappropriate marker for monitoring compliance to a gluten free diet.

BACKGROUND/AIMS: Gallbladder Carcinoma (GBC) is the most common and aggressive tumor of the biliary tract. Patients are typically diagnosed during advanced stages, and the mean overall survival is short. In our study, we aimed to demonstrate the uptake patterns of (18)F-FDG PET/CT in GBC, as well as its association with survival and diagnostic value during the initial stage. MATERIALS AND METHODS: Overall, 17 patients with GBC were retrospectively included in the study. (18)F-FDG PET/CT study was performed for pretreatment staging. Two different standardized uptake values (SUVmax and SUVmean), metabolic tumor volume 40% (MTV40), and tumor lesion glycolysis (TLG) of the primary tumors were compared between the clinical and histopathological groups. RESULTS: Of the 17 patients, 11 were women (64.7%), and 6 (35.3%) were men. The mean age of the patients was 69.7±8.8 years. (18)F-FDG uptake was detected in all lesions. Mean SUVmax was calculated to be 15.4±13.7 (median=10.6, range=3.4–46.8). All distant metastases (52.9%) were detected in the liver. Semiquantitative metabolic parameters (SUVmax and SUVmean, MTV40, and TLG) obtained from patients with distant metastasis were not significantly higher than those without distant metastasis. Similar results were obtained in patients with and without nodal metastasis. No statistically significant intergroup difference was observed regarding metabolic parameters. However, a statistically significant negative correlation was observed between the patient’s age and the SUVmax of the primary lesion and metastatic lymph nodes (r=−0.564, p=0.018). During 10.7±10.4 months of mean follow-up, the mean survival of patients with distant metastases (6.1±11.0 months) was significantly shorter than that of patients with no organ metastases (15.8±7.1 months). CONCLUSION: In our study, distant metastases and age were observed to be crucial prognostic factors in patients with gallbladder carcinoma (GBC). In addition, we believe that (18)F-FDG PET/CT imaging will help to stage the GBC, detect nodal and distant metastasis, and evaluate the metabolic state of gallbladder lesions.

Aim: the purpose of this study was to determine the anxiety levels and needs of those fathers whose children were hospitalized in a pediatric surgery intensive care unit. Materials and Methods: This cross-sectional study was conducted with the fathers of children hospitalized in a pediatric surgery intensive care unit in 2016/2017 by using the critical care family needs inventory (CCFNI), and State and Trait Anxiety scale. Setting: Turkey, a university hospital. Results: This study included 113 fathers. the fathers’ mean age was 36.6±6.31 years. There was a weak positive correlation between the scores the fathers obtained from the State Anxiety scale and the CCFNI. There was a difference between the fathers’ intensive care needs in terms of their education levels. While ‘‘feeling that hospital personnel are attentive to the patient’’ was important for 92% of the fathers, ‘‘being sure that as much care as possible is given” was important for 88.5% and ‘‘being informed about the patient at least once a day’’ was important for 85.8%. Conclusion: the anxieties and needs of the fathers of the patients staying in a pediatric surgery intensive care unit were high, particularly in those with a low educational level. Health professionals should be aware of the fathers’ feelings, needs and stressors so that they can provide interventions specific to fathers.

Objective: Periesophageal vagal plexus injury is a complication of cryoablation for atrial fibrillation (AF). The aim of this study is to investigate the effect of cryoablation on esophageal functions and to determine the relationship between esophageal temperature and esophageal motility. Methods: Twenty patients with symptomatic paroxysmal AF who underwent cryoablation were included in this study. The lowest cryoballoon temperature for each pulmonary vein (PV) was recorded. Esophageal temperature was measured using an esophageal probe during each cryoapplication. Esophageal manometry was performed before the procedure and one day after the procedure for each patient in order to assess the esophageal functions. Results: During the procedure, the highest esophageal temperature change was found in the left-side PVs in 13 patients (65%) and in the right-side PVs in seven patients (35%). No correlation was found between the lowest cryoballoon temperature and esophageal temperature change (r=0.22, p=0.05). It was detected that the lower esophageal sphincter pressure and esophageal contraction amplitude pressure decreased after the procedure (before: 19.7+-9.3 mm Hg, after: 14.3+-4.9 mm Hg, p=0.001; before: 84.5+-28.3 mm Hg, after: 72.7+-34.3 mm Hg, p=0.005, respectively). Five patients (25%) developed gastrointestinal symptoms after the procedure. Conclusion: During cryoablation, esophageal temperature measurement can be performed to reduce the probability of esophageal injury. Cryoablation affects esophageal motility, and esophageal manometry can be performed to detect esophageal motility impairments in patients with gastrointestinal symptoms.

Pneumomediastinum is a disease characterized by the presence of air in the mediastinum. The disease is examined in two categories as spontaneous and secondary and frequently seen as a result of traumatic causes. In our study, we present a case of diffuse mediastinal and subcutaneous emphysema after strangulation, unrelated to penetrating injury. After detailed anamnesis, it was understood that it was not a simple penetrating injury but a complicated trauma. Anamnesis, clinical findings, and radiology should be compatible with each other. When necessary, detailed anamnesis should be insisted and the etiology of blunt trauma should be investigated, especially if mediastinal emphysema is detected. Complications such as tension pneumomediastinum, pneumopericardium, and mediastinitis can be seen which complicates the disease and can result in death.

Background/aim: The present study aimed to create a decision tree for the identification of clinical, laboratory and radio- logical data of individuals with COVID-19 diagnosis or suspicion of Covid-19 in the Intensive Care Units of a Training and Research Hospital of the Ministry of Health on the European side of the city of Istanbul. Materials and methods: The present study, which had a retrospective and sectional design, covered all the 97 patients treated with Covid-19 diagnosis or suspicion of COVID-19 in the intensive care unit between 12 March and 30 April 2020. In all cases who had symptoms admitted to the COVID-19 clinic, nasal swab samples were taken and thoracic CT was per- formed when considered necessary by the physician, radiological findings were interpreted, clinical and laboratory data were included to create the decision tree. Results: A total of 61 (21 women, 40 men) of the cases included in the study died, and 36 were discharged with a cure from the intensive care process. By using the decision tree algorithm created in this study, dead cases will be predicted at a rate of 95%, and those who survive will be predicted at a rate of 81%. The overall accuracy rate of the model was found at 90%. Conclusions: There were no differences in terms of gender between dead and live patients. Those who died were older, had lower MON, MPV, and had higher D-Dimer values than those who survived. Keywords: Survival algorithm; COVID-19 intensive care patients; CRT method.

Objective: The aim of the study was to evaluate the possible effects of calyceal choice for renal puncture under sonographic guidance on the outcomes of percutaneous nephrolithotomy (PNL). Materials and Methods: A total of 70 patients for whom ultrasound-guided PNL was planned for 20–30-mm single renal pelvic stones were prospectively allocated to group 1 (n:35) with middle calyx entry or group 2 (n:35) with lower calyx entry. Procedure-related parameters such as duration of operation, stone-free rates, complication rates, and radiation exposure time were analyzed in detail. Results: The mean age of the patients was 45.67 ± 1.50 years and the mean stone size was 316.4 ± 17.95 mm2. There was no significant difference regarding the age, BMI, stone burden, and the grade of hydronephrosis between the groups. Skin to collecting system distance was significantly shorter in the middle calyx entrance (p = 0.021). Total duration of the procedure was again significantly shorter in group 1 cases (74.69 ± 2.94 min) than in group 2 (84.29 ± 4.25 min) (p = 0.003). Regarding the success rates, the postoperative stone-free rate was higher in group 1 (91.4% in group 1, 80.0% in group 2, p = 0.305). Last, there was no statistically significant difference in hemoglobin reduction rates, blood transfusion requirements, and complication rates between the 2 groups. Conclusion: Getting access to the renal pelvis through the middle calyx during ultrasonic guided PNL procedure is more advantageous to lower the calyceal approach by reducing both the duration of the PNL procedure with significantly higher stone-free and comparable complication rates.

Pediatric gastroenteritis is a potentially fatal disease that accounts for 10% of childhood deaths. The main risk is environmental factors and nutrition. Arsenic (As) is commonly found in the earth's crust. As is an essential element that can form many organic compounds. In children, it causes diarrhea, gums, tongue lesions, diabetes, conjunctivitis, ocular opacity, and impaired immune response. It also causes low growth, mental retardation, and neurological problems. It is also known as the cause of many cancers that originate at an early age. Regionally, there is an iron and steel industry for almost a century. According to the Rome IV criteria, the blood and stools of 50 children aged 6-18 years, male and female, living in our province with functional gastrointestinal disease (FGD), were screened for As, and compared with the Healthy group (control) of 30 children. The results were evaluated with the Mann-Whitney Rank Sum Test. When blood and stool As values in males were compared with control samples, a high level of significance (p = 0.001) was found between both blood and stool As values in sick males and the control group (p < 0.005). In females, blood and stool As median values were also highly significant when compared with the control group (p = 0.001). According to these data, when the sick children (children with male and female gender) are compared with the healthy ones, the difference is highly significant (p < 0.005). High blood As levels in children indicate environmental pollution. It can be said that blood As levels are high as a result of food, water, and inhaler exposure. The presence of a high level of significant difference in stool means that the amount of As is high in the foods consumed daily. High levels of As are in blood and stools; It was evaluated that FGD could be the cause of nausea, diarrhea, vomiting, and colic. The increase in blood and stool As values due to environmental pollution is an important reason for FGD. For diseases of uncertain cause (such as FGD) resulting from chronic As exposure, blood and especially stool As values are more significant than urinary As levels. In conclusion, As a diagnostic criterion, it was concluded that blood and stool As values are an important marker in children with functional abdominal pain with other metals., Karabuk University Scientific Research Projects Unit, We would like to thank Karabuk University Scientific Research Projects Unit for their support for our study.

Recently, we reported oligoadenylate synthetase 1 (OAS1) contributed to the risk of Alzheimer’s disease, by its enrichment in transcriptional networks expressed by microglia. However, the function of OAS1 within microglia was not known. Using genotyping from 1313 individuals with sporadic Alzheimer’s disease and 1234 control individuals, we confirm the OAS1 variant, rs1131454, is associated with increased risk for Alzheimer’s disease. The same OAS1 locus has been recently associated with severe coronavirus disease 2019 (COVID-19) outcomes, linking risk for both diseases. The single nucleotide polymorphisms rs1131454(A) and rs4766676(T) are associated with Alzheimer’s disease, and rs10735079(A) and rs6489867(T) are associated with severe COVID-19, where the risk alleles are linked with decreased OAS1 expression. Analysing single-cell RNA-sequencing data of myeloid cells from Alzheimer’s disease and COVID-19 patients, we identify co-expression networks containing interferon (IFN)-responsive genes, including OAS1, which are significantly upregulated with age and both diseases. In human induced pluripotent stem cell-derived microglia with lowered OAS1 expression, we show exaggerated production of TNF-α with IFN-γ stimulation, indicating OAS1 is required to limit the pro-inflammatory response of myeloid cells. Collectively, our data support a link between genetic risk for Alzheimer’s disease and susceptibility to critical illness with COVID-19 centred on OAS1, a finding with potential implications for future treatments of Alzheimer’s disease and COVID-19, and development of biomarkers to track disease progression.

BACKGROUND The antifibrotic drugs nintedanib and pirfenidone reduce disease progression in idiopathic pulmonary fibrosis (IPF) and have also shown to improve survival. Switching first-line antifibrotic drug may required in IPF due to disease progression or intolerable adverse effects. The aim of this study was to assess the safety and efficacy of second-line antifibrotic treatment in patients with IPF. MATERIAL AND METHODS This retrospective, multicenter study was conducted at three referral interstitial lung disease centers who received first-line antifibrotics more than one month and switched the treatment to a second-line antifibrotic agent during January 2016-June 2021. The drug's safety was evaluated based on the type of adverse effect. Disease progression was defined as an absolute decline in FVC of >10% within 12 months with or without radiological progression. RESULTS Among 629 consecutive patients with IPF, 66 patients switched antifibrotics. The median duration of antifibrotics was 13 (1-41) months prior to the switch, and 14 (2-42) months after the switch. The mean age was 70.6 ± 8.9 years and, median FVC (%) was 72.1 ± 18.7 at the initiation of first-line antifibrotics. The most common reason for the switch was disease progression (56%) followed by severe adverse effects (SAEs) (44%). SAEs were significantly less observed after the switch compared before the switch (43.9% vs12.1%, respectively, p

Gonorrhea is a sexually transmitted infection. It is caused by gonococci of the genus Neisseria. The literal translation of the disease means "semen flow". Hygienic rules must be followed. Treatment must be carried out correctly. Key words: gonorrhea, preqnancy, gonococcus

The experience of developed countries in recent years convincingly shows that increasing the efficiency of agro-industrial production is achieved mainly due to the intensification of the successful activities of innovators (i.e., the scientific and technical sphere of industry). The end result of innovation is the creation of innovations and their direct development in production, which will contribute to a systematic and increasingly progressive organizational, economic, technical and technological renewal and increase in the efficiency of agro-industrial production. Key words: entrepreneurship, innovative development, efficiency, business, production

The main prevention of rubella infection during pregnancy is to be vaccinated against this disease in preparation for pregnancy. Before you decide to get vaccinated against rubella, you need to have a special laboratory test to detect antibodies to the rubella virus in your blood to check if you are immune to this infection. The fact is that in some cases it is impossible to determine whether you are sick with rubella. Because in many cases, the disease can be latent or with a very limited number of symptoms, in which case, naturally, the body develops specific antibodies against the virus. Doctors believe that in this case, the body's immune response will be strengthened. It is recommended that the velvet vaccine be given at least 3 months before the planned date of pregnancy. Key words: pregnancy, rubella, fetus, infection

Aim: This study aims to define the efficacy and safety of a different obturator nerve block technique using fluoroscopy and nerve stimulation device during transurethral resection of bladder tumor (TUR-BT). Methods: Sixty patients with lateral bladder wall tumors who had TURBT were retrospectively analyzed for the formation of obturator reflex. Thirty patients received spinal anesthesia (SA) and 30 patients received SA combined with an obturator nerve block (ONB). ONB was performed in the lithotomy position. A percutaneous needle was advanced to the superolateral portion of the obturator foramen under fluoroscopic guidance. The nerve was localized with a nerve stimulation device and 5 mL of 2% prilocaine was injected to perineural area. Additionally, the tumor base was marked intravesically by resectoscope with fluoroscopy and 5 mL of %2 prilocaine was administered to nearby tissue. Obturator reflex formation reflex-related related complications were compared between the two groups. Results: The results of our study yielded a statistically significant difference in the favor of ONB compared to SA alone for the occurrence of obturator reflex (13% vs 43%, p=0.020), bladder perforation (0% vs 23.3%, p=0.002), and absence muscle tissue in the pathological specimen (10% vs 40%, p=0.01). Conclusion: ONB with the help of a nerve stimulation device, directed by fluoroscopy is effective to prevent obturator reflex and related complications.

The microsurgical varicocelectomy is the gold standard treatment with a low recurrence rate and less postoperative complications. We compared the surgical outcomes and difficulty in intra-operative vascular Doppler ultrasound-assisted microscopic varicocelectomy (IVDU-MV) with MV in primary and recurrent varicocele. A total of 228 infertile patients with clinically palpable varicocele were included in the study. One hundred fifteen patients were operated on with the standard MV approach, whereas the other 113 patients were operated on with IVDU-MV. Perioperative outcomes, sperm parameters and operative difficulty of the procedure were evaluated. The operative times were significantly shorter for the IVDU-MV group for primary and recurrent varicocele (p = .001). Mean number of veins ligated for primary and recurrent varicocele was significantly higher in the IVDU-MV group than in the MV group (6 +/- 1.4 vs. 4.8 +/- 1.8 and 3.7 +/- 0.9 vs. 2.9 +/- 1.2; p < .01). The increase in mean sperm motility was significantly higher in the IVDU-MV group for both primary and recurrent varicocelectomy patients (p < .05). A significant number of IVDU-MV procedures were described as easy in both primary and recurrent varicocelectomy procedures (p = .006). The use of Doppler ultrasound(US) revealed advantages in ligating veins, preserving arteries and improving sperm motility and facilitates the operation for the surgeon, especially during recurrent varicocele repair. WOS:000530729800001 32379354 Q3