Search

Hizli, Omer/0000-0001-6822-2679 WOS: 000491220700012 PubMed: 30919461 Objectives To investigate the olfactory fossa depths and lateral lamella lengths of patients with different types of developmental disorders of paranasal sinuses in comparison with normal controls. Study Design Retrospective, archival, radio-anatomical study. Methods We included 58 patients with maxillary sinus hypoplasia, 50 patients with frontal sinus hypoplasia/aplasia, 50 patients with sphenoid sinus hypoplasia/aplasia, and 40 normal controls. Reviewing paranasal computerized tomography scans, we noted the olfactory fossa depths and lateral lamella lengths of all the groups and compared between the hypoplasia groups and the control group. Results Compared with the normal controls, the maxillary hypoplasia group (P < 0.001), frontal hypoplasia/aplasia group (P = 0.004), and sphenoid hypoplasia/aplasia group had significantly deeper olfactory fossa (P = 0.003). The mean lateral lamella lengths in the type 1, type 2, and type 3 hypoplastic maxillary sinus groups were significantly greater compared with that in the control group (P < 0.001). Additionally, the mean lateral lamella lengths in the hypoplastic frontal sinus, aplastic frontal sinus, and hypoplastic sphenoid sinus groups were significantly greater compared with that in the control group (P < 0.001). Conclusion The patients with pneumatization defects of the maxillary, frontal, and sphenoid sinuses had deeper olfactory fossa and longer lateral lamella related to increased risk of skull base injury during endoscopic sinus surgery. Level of Evidence 3 Laryngoscope, 129:2458-2463, 2019

Background: Diabetic peripheral neuropathy (DPN) is one of the most common complications of Type 2 diabetes mellitus (T2DM). This study was conducted to investigate the possible association between interleukin-1β (IL-1β) rs16944 /IL-1 receptor antagonist (IL-1Ra) VNTR variants and genetic susceptibility to DPN in a Turkish cohort. Methods: A total of 200 subjects were enrolled in this study, 98 patients with DPN and 102 cases of age and sex-matched healthy controls. Genotyping was performed for all individuals using PCR-RFLP analysis. Results: IL-1β rs16944 CC genotype had a 3.20-fold increased risk for DPN (p=0.0003, OR=3.20, 95% Cl:1.72-5.96). IL-1β rs16944 CT genotype was higher in healthy control than patients (p=0.004). IL-1β rs16944 C allele was higher in the patient group compared to controls while T allele was lower in patients than controls (p=0.003). IL-1Ra VNTR a1/a1 and a2/a2 genotypes were lower in DPN patients while a1/a2 genotype was higher in patients (p=0.045). The patients carrying a1/T haplotype had decreased risk of DPN than control groups (p=0.004). The patients carrying a2/a2 genotype had lower HDL level (p=0.039). The subjects carrying a2/a2 genotype had higher total cholesterol level while the subjects carrying a1/a2 genotype had lower total cholesterol (p=0.026 and p=0.037, respectively). IL-1Ra a1 allele was associated with higher HDL level (p=0.041). Conclusion: Findings of this study indicated that the IL-1β rs16944 and IL-1Ra VNTR variants are probably to be associated with susceptibility DPN risk in a Turkish cohort.

The aim of this study was to assess the opinions of staff working in workplace-violence related units on violence against nurses. A qualitative and descriptive design was used. The participants were seven nurses, one biologist, and one social worker who agreed to attend an interview and worked in employee rights unit or occupational health and safety unit. Data were collected from June to December 2017. The interviews were analyzed with content analysis. Four main themes were identified, and the themes were the following: (1) risk factors; (2) reporting of violence; (3) consequences of violence; and (4) prevention and control. In summary, factors related to the patient, the nurse, and the physical structure of the hospital were determined.

Inter-individual variations in the genes encoding xenobiotic-metabolizing enzymes have been reported to alter susceptibility to various diseases involving hematological disorders. The purpose of this case–control study was to investigate the relationship between CYP2D6*4 and GSTP1 Ile105Val polymorphisms and the risk of developing BCR-ABL1 negative myeloproliferative neoplasms (MPN). PCR-RFLP was used for genotyping single nucleotide polymorphisms (SNP) in CYP2D6 and GSTP1 in 139 patients with MPN and 126 controls. There was a significantly increased risk for developing BCR-ABL1 negative MPN for the group bearing the CYP2D6*4 variant allele (X2: 4.487; OR 1.738; 95% CI 1.040–2.904; p = 0.034). The platelet count was higher in CYP2D6*4 allele carriers (p = 0.047). There was no association between the GSTP1 Ile105Val polymorphism and the risk of developing MPNs. MPN patients bearing the GSTP1 Ile105Val variant allele had a higher prevalence of bleeding complications (X2: 7.510; OR 4.635; 95% CI 1.466–14.650; p = 0.006). Our study provides new data that the CYP2D6*4 polymorphism may be associated with an increased risk to develop MPNs while the GSTP1 Ile105Val polymorphism does not show such an association. To our knowledge, the current study is the first to investigate the relationship between CYP2D6*4 and GSTP1 Ile105Val polymorphisms and the risk of developing MPNs in the Turkish population. Further studies with more patients and controls are needed to support our data. This study was financially granted by the Research Fund of İstanbul University Scientific Projects Unit (Project No: BAP/23924).

Childhood maltreatment (CM) is a global problem with serious life-long consequences. The purpose of the present study was to determine the prevalence of CM among university students and to assess the associations between CM and the health-related quality of life (HRQOL) in adulthood. The present descriptive cross-sectional study involved 626 students who had been selected by means of a cluster sampling method from among all the students studying in Giresun University. CM was assessed with the Childhood Trauma Questionnaire at interview and HRQOL was assessed using the Duke Health Profile. Data were analyzed using descriptive statistics, Pearson chi-square tests, independent samples t-test, and binary logistic regression. About half (43.5%) of the students reported exposure to some form of CM. Logistic regression analysis showed that male gender, parental separation or divorce, poorer familial relationships, lower socioeconomic status, smoking and alcohol consumption were significantly associated with CM. A significant correlation emerged between CM and physical health, general health, perceived health, self-esteem, anxiety, pain and disability. CM is common among university students in Turkey. Students who had experienced CM had significant and sustained losses in HRQOL in adulthood relative to students who had not experienced maltreatment.

Aims Hydrogen sulfide (H2S) is shown in ocular tissues and suggested to involve in the regulation of retinal circulation. However, the mechanism of H2S-induced relaxation on retinal artery is not clarified yet. Herein, we aimed to evaluate the role of several calcium (Ca2+) signaling and Ca2+ sensitization mechanisms in the relaxing effect of H2S donor, NaHS, on retinal arteries. Materials and methods Relaxing effects of NaHS (10−5–3 × 10−3M) were determined on precontracted retinal arteries in Ca2+ free medium as well as in the presence of the inhibitors of Ca2+ signaling and Ca2+ sensitization mechanisms. Additively, Ca2+ sensitivity of the contractile apparatus were evaluated by CaCl2-induced contractions in the presence of NaHS (3 × 10−3M). Functional experiments were furtherly assessed by protein and/or mRNA expressions, as appropriate. Key findings The relaxations to NaHS were preserved in Ca2+ free medium while NaHS pretreatment decreased the responsiveness to CaCl2. The inhibitors of plasmalemmal Ca2+-ATPase, sarcoplasmic-endoplasmic reticulum Ca2+-ATPase, Na+-Ca2+ ion-exchanger and myosin light chain kinase (MLCK) unchanged the relaxations to NaHS. Likewise, Ca2+ sensitization mechanisms including, rho kinase, protein kinase C and tyrosine kinase were unlikely to mediate the relaxation to NaHS in retinal artery. Whereas, a marked reduction was determined in NaHS-induced relaxations in the presence of MLCP inhibitor, calyculin A. Supportively, NaHS pretreatment significantly reduced phosphorylation of MYPT1-subunit of MLCP. Significance The relaxing effect of NaHS in retinal artery is likely to be related to the activation of MLCP and partly, to decrement in Ca2+ sensitivity of contractile apparatus.

Purpose: The objective of this study was to investigate the effects of music therapy, hand massage, and kaleidoscope usage on nausea and vomiting, pain, fear, and stress in 7-year-old to 11-year-old children after circumcision. Design: This study was a prospective and randomized controlled trial. Methods: The study was conducted at the pediatric surgery unit in a hospital in Turkey. The children were assigned to four groups through randomization performed using a computer program: group 1 was the control group with children who received no intervention; group 2 received hand massage; group 3 were distracted using kaleidoscope; and group 4 received music therapy. Findings: There was a significant difference between the postoperative pain scores of the children in the intervention and control groups after the intervention (P < .05). This difference was found to be caused by the music therapy and kaleidoscope methods. There was a significant difference between the intervention and control groups' postoperative fear and anxiety levels in favor of the kaleidoscope group after the intervention (P < .05). But, no significant difference was found between the groups for the children's postoperative vomiting and nausea levels after the intervention (P > .05). Conclusions: Distraction with music therapy and kaleidoscope is recommended for use in the postoperative period in children with circumcision to reduce the severity of their pain, fear, and anxiety.

Arsava, Ethem Murat/0000-0002-6527-4139 WOS: 000505793800054 PubMed: 31810719 Background and Aims: The characteristics of clot causing acute ischemic stroke, such as size, content, and location, are among the main determinants of response to intravenous tissue plasminogen activator [IV tPA]. Clot heterogeneity and permeability are under-recognized features that might provide additional information in predicting the efficacy of IV tPA. Methods and Patients: Patients with proximal middle cerebral artery occlusion treated with "IV tPA alone" were included. The mean Hounsfield's unit (HU) value, as objective measure of clot attenuation, and its standard deviation (SD), as proposed measure of clot heterogeneity, were obtained. The difference in HU values between CT Angiography and CT was defined as "clot permeability", or "perviousness'. The size (length and volume-mm3) of pre-clot pouch and occluding clot along with ASPECT score and Maas' silvian and leptomeningeal collateral score were measured. Results: The study included 84 cases (44 women, age: 68 +/- 14 years, pretPA NIHSS: 16 +/- 5). Patients with excellent response to tPA (31%) had lower thrombus volume (37.54 +/- 32.37 versus 63.49 +/- 37.36, P = .009) and heterogeneity (4.05 +/- 1.49 versus 5.35 +/- 2.34, P = .011), along with higher clot permeability (48 +/- 35.48 to 31.32 +/- 18.62, P = .006). However, significance of permeability did not survived in the regression analysis with adjustment for NIHSS (beta:-.296, P = .003); clot volume (beta:-.240, P = .014) and collateral status (beta:.346, P < .001). In patients with good prognosis, clot volume was significantly lower (37.76 +/- 30.08 versus 67.57 +/- 37.83, P < .001), whereas permeability was significantly higher (43.97 +/- 32.33 versus 31.13 +/- 19.01, P = .026). However, this effect did not persist in the regression analysis after adjustment for NIHSS (beta:-.399, P < .001), collateral status (beta:.343, P < .001) and clot volume beta:-.297, P = .001). Clot permeability was significantly higher (45.78 +/- 36.34 versus 33 +/- 20.2, P = .045) and heterogeneity was lower (4.1 +/- 1.55 to 5.27 +/- 2.32, P = .028) in patients with dramatic response to tPA (27%). In patients responding positively to IV tPA (48%), clot permeability was numerically higher (39.85 +/- 31.79 to 33.47 +/- 19.28, P = .268), while clot volume (48.15 +/- 34.5 to 62.07 +/- 39.62, P = .093) was lower. Clot volume, permeability and heterogeneity did not show a significant difference in any (38.1%) or symptomatic (8.3%) bleeders after IV tPA. The chance of IV tPA to be beneficial increased in patients with clot volume lower than 45 mm(3), with an increased likelihood of this benefit to be observed within the first day after IV tPA. Our detailed explorative ROC analysis was not able to detect a volume threshold above which the positive effect of IV tPA disappeared. Conclusion: Clot volume is critical for the effectiveness of IV tPA in acute ischemic stroke. Clot permeability and heterogeneity may modify its effect. CT technologies, which are readily available when evaluating a stroke patient in an emergency setting, provide us with useful parameters regarding the size, permeability and heterogeneity of the clot.

YASIM, Alptekin/0000-0003-3397-711X WOS: 000526895400004 PubMed: 31559589 Objective This study aimed to investigate the preventive effects of a high-dose vitamin D administered preoperatively on the post-operative atrial fibrillation (POAF) occurrence in patients with insufficient or deficient serum vitamin D levels who underwent coronary artery bypass grafting (CABG) surgery. Methods The study was a randomized controlled, blinded and parallel-arm trial conducted on 116 who had vitamin D deficiency or insufficiency during the pre-operative evaluation were included in the study conducted between January 2018 and January 2019. Patients were divided into those who received oral vitamin D (treatment group; n = 58) and those who did not (control group; n = 58) 48 h before CABG surgery. In the treatment group, patients with vitamin D deficiency were administered 300.000 IU vitamin D orally and those with vitamin D insufficiency 150.000 IU 48 h preoperatively. Patients were followed up during hospitalisation process with respect to POAF. Results Both groups showed no significant differences with regard to age, gender, body mass index, creatine level, left atrial diameter, pre-operative drug use, calcium level, ejection fraction, diabetes mellitus and hypertension. The ratio of POAF occurrence found in the treatment and control groups were 12.07% and 27.59%, respectively. Vitamin D treatment was found to reduce the risk of POAF development by 0.24 times (p = 0.034). Conclusion In this study with sufficient sample size, preoperative short-term high-dose vitamin D supplementation was found to be significantly preventive to the occurrence of POAF in patients with vitamin D insufficiency and deficiency who underwent CABG surgery.

Bone metastases are a frequent complication in prostate cancer, and several studies have shown that vitamin D deficiency promotes bone metastases. However, while many studies focus on vitamin D's role in cell metabolism, the effect of chronically low vitamin D levels on bone tissue, i.e. insufficient mineralization of the tissue, has largely been ignored. To investigate, whether poor tissue mineralization promotes cancer cell attachment, we used a fluorescence based adhesion assay and single cell force spectroscopy to quantify the adhesion of two prostate cancer cell lines to well-mineralized and demineralized dentin, serving as biomimetic bone model system. Adhesion rates of bone metastases-derived PC3 cells increased significantly on demineralized dentin. Additionally, on mineralized dentin, PC3 cells adhered mainly via membrane anchored surface receptors, while on demineralized dentin, they adhered via cytoskeleton-anchored transmembrane receptors, pointing to an interaction via exposed collagen fibrils. The adhesion rate of lymph node derived LNCaP cells on the other hand is significantly lower than that of PC3 and not predominately mediated by cytoskeleton-linked receptors. This indicates that poor tissue mineralization facilitates the adhesion of invasive cancer cells by the exposure of collagen and emphasizes the disease modifying effect of sufficient vitamin D for cancer patients. This work has been financially supported by Ministry of National Education of Turkey; http:// www.meb.gov.tr/en (ES), by the German Excellence Initiative via the Nanosystems Initiative Munich; https://www.nano-initiative-munich.de/de (MB), and the Bavarian State Ministry for Science and Art via CANTER Forschungsschwerpunkt; www.stmwk.bayern.de (DZ, HCS, SS).

WOS: 000515006000002 PubMed: 31325107 Introduction Postoperative bleeding requires blood transfusion and surgical re-exploration that can affect the short- and long-term postoperative outcomes. Interventions that can be used in the postoperative period to reduce blood loss should be developed. Continuous postoperative pericardial flushing (CPPF) with an irrigation solution may reduce blood loss by preventing the accumulation of clots. This study examined the feasibility and acceptability of CPPF for reducing bleeding after coronary artery bypass surgery. Methods This pilot study adopted a prospective and group comparison design. Between January and April 2018, 42 patients who underwent isolated coronary artery bypass surgery received CPPF from sternal closure up to 8 h postoperative. The mean actual blood loss in the CPPF group was compared to the mean of retrospectively group (n = 58). In the CPPF group, an extra infusion catheter was inserted through one of the tube incision holes and an irrigation solution (0.9% NaCl at 38 degrees C) was delivered to the pericardial cavity by using a volumetric pump. Safety aspects, feasibility issues, and complications were documented. The primary outcome was blood loss, and it was assessed 18 h after the surgery. Results CPPF was successfully completed in 40 patients (95.24%). Method-related complications were not observed. Feasibility was good in this experimental setting. Blood loss was lower in the CPPF group (257.24 mL) than non-CPPF group (p < 0.001). Conclusions CPPF after coronary artery bypass grafting surgery is safe, effective, feasible, and acceptable. However, standardized randomized clinical trials are necessary to draw definitive conclusions.

Chi, Hsin/0000-0001-8130-0248; ATLIHAN, Remzi/0000-0003-3924-7812; GUNCAN, Ali/0000-0003-1765-648X WOS: 000429319200013 PubMed: 29490075 We compared rearing Harmonia dimidiata (F.) (Coleoptera: Coccinellidae) on four combinations of Aphis gossypii Glover (Hemiptera: Aphididae), and eggs of Bactrocera dorsalis Hendel (Diptera: Tephritidae), using the age-stage, two-sex life table. The four combinations were: both larvae and adults were reared on aphids; larvae were reared on aphids and adults were reared on fresh fruit fly eggs; larvae were reared on lyophilized fruit fly eggs and adults were reared on aphids; and larvae were reared on lyophilized eggs and adults were reared on fresh eggs. The highest intrinsic rate of increase (r = 0.1125 d(-1)) and net reproductive rate (R-0 = 260.7 offspring) were observed when both larval and adult stages of H. dimidiata were reared on A. gossypii. When B. dorsalis eggs were used as rearing media for larvae, adults, or both, the values of r and R-0 were significantly decreased. The lowest values (r = 0.0615 d-1 and R-0 = 38.6 offspring) were observed when both larvae and adults were reared entirely on B. dorsalis eggs. Despite the lower r and R-0 values, our results showed that B. dorsalis eggs could be considered as an adequate, less expensive alternative diet for rearing H. dimidiata because of the time and labor savings resulting from the ease of preparation and the ability to store the eggs for timely usage. The mass-rearing analysis showed that the most economical rearing system was to rear larvae on A. gossypii and adults on B. dorsalis eggs. Ministry of Science and TechnologyMinistry of Education, Culture, Sports, Science and Technology, Japan (MEXT) [NSC 98-2313-B-005-020-MY3] We would like to thank Ms. Wun and Ms. Yeh for assistance with the experiments, especially the mass culture of all insects and host plants. This research was partially supported by grants to H.C. from the Ministry of Science and Technology (NSC 98-2313-B-005-020-MY3).

Alisik, Murat/0000-0003-0434-3206; EREL, Ozcan/0000-0002-2996-3236; WOS: 000444369100007 PubMed: 30160158 OBJECTIVES: The aim of the study was to determine dynamic thiol-disulphide homeostasis in patients with ulcerative colitis, compare it with those of healthy control and to investigate the relationship between the severity of the disease and homeostasis METHODS: A total of 78 patients and 58 healthy subjects were included in the study. Serum native thiol, total thiol and disulphide amounts were measured by using a novel automated method. Obtained results were compared and relationships were determined by correlation analysis. RESULTS: Serum native thiol, total thiol, disulphide amounts and disulphide/native thiol percent ratio (index) were significantly lower (p = 0.003 for index ratio and p < 0.001 for other parameters) in patients with ulcerative colitis than in healthy controls. Native thiol, total thiol and disulphide amounts were significantly higher (p < 0.001) in patients with ulcerative colitis in remission than in patients with active ulcerative colitis and near to those of healthy control. There were significant negative correlations between the severity of the disease and thiol-disulphide homeostasis parameters (r = -0.55, p < 0.001 for native thiol; r = -0.64, p < 0.0001 for total thiol; r = -0.65, p < 0.001 for disulphide and r = -0.33, p = 0.011 for index). CONCLUSION: The thiol-disulphide homeostasis was weakened in ulcerative colitis. Strong correlations between the activity of the disease and thiol-disulfide homeostasis indicate that homeostasis may play a role in the pathogenesis of the disease (Tab. 3, Fig. 3, Ref. 30). Text in PDF www.elis.sk.

GUNCAN, Ali/0000-0003-1765-648X WOS: 000407164900058 PubMed: 28334379 The filbert aphid Myzocallis coryli (Goeze) is a serious pest of hazelnut in North America, Italy, Spain, and Turkey. To evaluate the resistance of hazelnut to this insect, aphids were reared on five major cultivars ('Tombul,' 'Palaz,' 'Cakildak,' 'Fosa,' and 'Mincane') under laboratory conditions. The developmental times of preadult and adult stages, total longevity, reproduction, and life table parameters were analyzed according to age-stage, two-sex life table theory, in which the stage differentiation and variable developmental rates among individuals could be described. The intrinsic rate of increase (r) and finite rate of increase (lambda) varied among the cultivars. The highest values were found for aphids reared on Cakildak (r = 0.2019 d(-1), lambda = 1.2238 d(-1)), which did not differ significantly from Mincane (r = 0.1957 d(-1), lambda = 1.2161 d(-1)), whereas these parameters were lowest for Palaz (r = 0.1622 d(-1), lambda = 1.1761 d(-1)) and Fosa (r = 0.1677 d(-1), lambda = 1.1826 d(-1)). Based on longer preadult development time, shorter adult longevity, shorter reproductive period, together with the demographic parameters, Palaz and Fosa provide a relatively unfavorable environment for the filbert aphid. The results obtained from demographic data together with estimates of pest growth potential generated by computer projection based on age-stage, two-sex life table theory, demonstrate that both Palaz and Fosa are resistant cultivars for M. coryli and can be considered in hazelnut integrated pest management and hazelnut breeding programs.

WOS: 000434320400005 PubMed: 28322651 Hospitalization of an infant is a difficult situation for the family, and parents require support from the health care team during this difficult time. The aim of this study was to investigate the effect of spiritual care on levels of stress in mothers with infants in a neonatal intensive care unit. This spiritual care study was performed by comparing control and spiritual care pre- and posttest groups. The study population included 62 mothers. The Mother-Baby Introductory Information Form and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) were used for data collection. Prior to spiritual care, no significant difference was found between the mothers' PSS:NICU scores, whereas following spiritual care, there was a significant difference between PSS:NICU scores of the mothers, in favor of the spiritual care group (p < .05). Findings indicate that nurses should be aware and consider the spiritual needs of mothers and must identify and meet these needs.

Background The determination of the protective and risk factors associated with Internet gaming disorder (IGD) is among the most important pathways to the development of prevention strategies for IGD. Previous research has shown that familial factors are associated with IGD. In our study, we aimed to assess the parental attitude of adolescents with IGD and investigate psychiatric comorbidity. Methods We assessed family structure, family relationship, parental attitude (in a bi-directional assessment), and psychiatric comorbidity in 50 adolescents aged 12-18 years who meet DSM-5 criteria for IGD in comparison with the control group. Parental attitudes were assessed with the Parental Attitude Research Instrument (filled by the mother) and the Parenting Style Inventory (filled by adolescents). Results Our findings suggest that according to mothers' opinions there were no significant differences in the subscale scores between the IGD group and the control group. On the other hand, acceptance-involvement and psychological autonomy subscale scores of the PSI filled by adolescents were found to be significantly lower in the IGD group. Limit setting in areas other than the Internet was significantly lower in the IGD group. High rates of psychiatric comorbidity were also found in adolescents with IGD. Conclusions Our study identified that adolescents with IGD perceived their parents "cared less about them" and "minded less on their autonomy" compared with the control group. Our survey demonstrated that parental attitudes may be among the risk factors for IGD and the presence of psychiatric comorbidity may affect the management of IGD.

Demirelli, Erhan/0000-0002-0187-2156 WOS: 000514117700001 PubMed: 32072659 Aortic stiffness increases in patients with erectile dysfunction (ED) but it is not known whether aortic stiffness affects the degree of ED. In the present study, we aimed to determine whether there is any relationship between aortic stiffness and the severity of ED. Patients with ED were divided into 3 groups according to the International Index of Erectile Function (IIEF) scores. Mild ED was named as group 1, moderate ED as group 2 and severe ED as group 3. The values of fasting blood glucose (FBG), serum lipid values, total testosterone (T. tes), and free testosterone (F tes) were recorded. Aortic stiffness was determined by pulse wave velocity (PWV) and augmentation index (AIX) measurements. The mean or median values of the laboratory parameters among the groups were similar (p > .05). No statistical difference was found between the groups in terms of AIX value (p = .386). Mean PWV values were calculated as 7.26, 8.30 and 8.78 in group 1, group 2 and group 3 respectively. PWV values were significantly different between groups (p < .0001). PWV values were found to be increased with increasing severity of erectile dysfunction. Scientific Project Office of Giresun University [SAG-BAP-A-200515-30] Scientific Project Office of Giresun University, Grant/Award Number: SAG-BAP-A-200515-30

*Çayır, Serkan ( Aksaray, Yazar ) *Kayabaşı, Serkan ( Aksaray, Yazar ), Background: Tympanoplasty is regularly performed in various ages but data about the procedure in elderly is insufficient. Objectives: To compare the success rates and hearing outcomes of fascia and perichondrium grafts used for tympanoplasty in patients >65 years and to evaluate the prognostic factors affecting the success of tympanoplasty. Methods: Reviewing records of 49 elderly patients underwent tympanoplasty, two groups were constituted: perichondrium (25 patients) and fascia (24 patients) groups. Ages, genders, perforation sides, type and location of perforation, graft success rates, functional success rates and air–bone gap (ABG) gains were compared. Results: Overall graft success rate was 85.7%. After a mean follow-up of 23.3 ± 8.32 months, overall mean ABG gain was 11.33 ± 8.42 dB. Overall median postoperative ABG value (9 dB) was significantly lower compared to the median preoperative value (24 dB) (p

WOS: 000519233300001 PubMed: 31586281 Purpose We aimed at comparing the success and complications of early semirigid ureteroscopy (URS) and elective URS in ureteral calculi with renal colic that do not respond to analgesics. Methods We retrospectively analyzed the data of 690 patients with obstructive ureteral stones who underwent URS with stone retrieval. 247 patients who underwent early URS within the first 12 h were classified as group I and 443 patients who underwent elective URS as group II. Both groups were compared in terms of age, sex, creatinine, eGFR, stone size, laterality, location and number of stones, type of lithotriptor, presence of hydronephrosis and success and complication rates. Results The mean age of the patients was 50.4 (18-89 years) (p > 0.05). There was no statistically significant difference between the groups in terms of age, eGFR, side, presence of hydronephrosis, fever, mucosal damage, stone migration, perforated ureter, ureteral avulsion, ureteral stent insertion at the end of the surgery and sepsis (p > 0.05). Both groups had male dominance (p > 0.05). Creatinine was significantly lower in Group I (p < 0.05). The mean stone size was also significantly lower in Group I ( p < 0.05). Middle and proximal ureteral calculi were more common in Group II (p < 0.05). Multiple stones were higher in Group II (p < 0.05). The dominant type of lithotriptor used was pneumatic in Group I and laser in Group II (p < 0.05). Stone-free rates (SFRs) were higher in Group I (98% vs 90% in the first month) (p < 0.05). Postoperative hematuria and infection were more common in Group II (p < 0.05). Conclusions In selected cases, early ureteroscopy is an effective and safe method for distal ureteral calculi smaller than 10 mm that are painful and resistant to analgesic treatment.

cerik, idris bugra/0000-0003-1419-3950 WOS: 000471831300013 PubMed: 31038789 Background Pulmonary hypertension (PH) is one of the complications of human immunodeficiency virus (HIV) infection. Despite the emergence of effective therapies, pulmonary arterial hypertension is commonly seen, especially at advanced stages. At the time of diagnosis, a majority of patients are at New York Heart Association-Functional Class III or IV. Many of the current screening modalities are dependent on detecting a rise in pulmonary arterial pressure (PAP). However, high capacitance of the pulmonary circulation implies that early microcirculation loss is not accompanied by a change in resting PAP. Therefore, we aimed to demonstrate early changes in pulmonary vascular disease in HIV-infected patients with a new echocardiographic parameter, called as pulmonary arterial stiffness (PAS). Methods and Results Thirty-six HIV-infected patients and 36 age- and sex-matched healthy control subjects were enrolled in this study. PAS was calculated echocardiographically by using maximal frequency shift and acceleration time of the pulmonary artery flow trace. There was no significant difference in diastolic functions, right ventricular diameters, systolic PAP, inferior vena cava widths, right atrial area, and tricuspid annular plane systolic excursion values between the two groups. However, PAS was calculated as 24.3 +/- 6.4 Hz/msn in HIV-infected patients and 19.3 +/- 3.1 Hz/msn in healthy control group (P < 0.001). Increase in PAS was correlated with duration of HIV infection (P < 0.05). Conclusion Our results suggest that HIV infection affects pulmonary vascular bed starting early onset of disease and this can be demonstrated by an easy-to-measure echocardiographic parameter.

EgeUn###, BACKGROUND AND AIM: The combination of cetuximab with platinum and 5-fluorouracil (5-FU) chemotherapy prolongs survival in patients with metastatic or recurrent squamous-cell carcinoma of the head and neck (SCCHN). Biweekly (once in 2 weeks) administration of cetuximab requires fewer hospital visits and decreases treatment costs; therefore, it is more convenient both for the patients and for the healthcare providers. Here, we assessed the efficacy, safety, and tolerability of an alternative biweekly regimen of cetuximab in combination with platinum and 5-FU chemotherapy as a first-line treatment for these patients. METHODS AND MATERIALS: Medical records of patients with metastatic or recurrent non-nasopharyngeal SCCHN who were treated with a biweekly regimen of cetuximab (500 mg/m(2) on day 1), cisplatin (40 mg/m(2) on day 1) or carboplatin (target area under the curve 3.5 mg/ml x min on day 1), folinic acid (400 mg/m(2) on day 1), and 5-FU (400 mg/m(2) bolus on day 1 followed by continuous infusion of 2,400 mg/m(2) 5-FU over 46 h) were retrospectively reviewed. Survival estimates were calculated with the Kaplan-Meier method. RESULTS: In total, 60 patients were included. The median age of the patients was 60.5. The objective response rate was 53.3% (95% confidence interval [CI] = 40.7-65.9). The median progression-free survival duration was 6.8 months (95% CI = 5.5-8.1) and the median overall survival duration was 13.3 months (95% CI = 8.4-18.2). The most common grade 3 or 4 adverse events were neutropenia (28.3%) and leucopenia (13.3%). Grade 3 or 4 rash was observed in 3.3% of the patients. CONCLUSION: Biweekly administration of cetuximab, cisplatin, and 5-FU is an effective regimen with a favorable toxicity profile for the first-line treatment of metastatic or recurrent SCCHN. These results warrant further evaluation of this regimen in prospective trials.

Hizli, Omer/0000-0001-6822-2679; (Bingol) Hizli, Pelin/0000-0001-8919-3125 WOS: 000383312600004 PubMed: 26860231 Objective: To observe any changes in stria vascularis and cochlear hair cells in patients with syphilis. Materials and methods: We examined 13 human temporal bone samples from 8 patients with syphilis (our syphilis group), as well as 12 histopathologically normal samples from 9 age-matched patients without syphilis (our control group). We compared, between the two groups, the mean area of the stria vascularis (measured with conventional light microscopy connected to a personal computer) and the mean percentage of cochlear hair cell loss (obtained from cytocochleograms). Results: In our syphilis group, only 1 (7.7%) of the 13 samples had precipitate in the endolymphatic or perilymphatic spaces; 8 (61.5%) of the samples revealed the presence of endolymphatic hydrops (4 cochlear, 4 saccular). The mean area of the stria vascularis did not significantly differ, in any turn of the cochlea, between the 2 groups (P > 0.1). However, we did find significant differences between the 2 groups in the mean percentage of outer hair cells in the apical turn (P < 0.026) and in the mean percentage of inner hair cells in the basal (P = 0.001), middle (P = 0.004), and apical (P = 0.018) turns. In 7 samples in our syphilis group, we observed either complete loss of the organ of Corti or a flattened organ of Cord without any cells in addition to the absence of both outer and inner hair cells. Conclusion: In this study, syphilis led either to complete loss of the organ of Corti or to significant loss of cochlear hair cells, in addition to cochleosaccular hydrops. But the area of the stria vascularis did not change. (C) 2016 Elsevier Ireland Ltd. All rights reserved. NIH (NIDCD)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Deafness & Other Communication Disorders (NIDCD) [U24 DC011968-01]; International Hearing Foundation; Starkey Foundation; 5M Lions International; Scientific and Technological Research Council of Turkey (TUBITAK) ScholarshipTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) This project was funded by NIH (NIDCD), grant number U24 DC011968-01; the International Hearing Foundation; the Starkey Foundation; and the 5M Lions International. Omer Hizh and Serdar Kaya received the Scientific and Technological Research Council of Turkey (TUBITAK) Scholarship.

bilge, okan/0000-0002-8993-2271; Taskiran, Dilek/0000-0002-4505-0939 WOS: 000390431000008 PubMed: 27881053 Purpose: The aim of the present study is to investigate the protective effects of oxytocin (OT) on diabetic neuropathy (DNP) in rats. Materials and methods: Eighteen rats were used to induce diabetes using single dose streptozotocin (STZ, 60 mg/kg). Diabetic DNP was verified by electromyography (EMG) and motor function test on 21st day following STZ injection. Six rats served as naive control group and received no drug (n=6). Following EMG, diabetic rats were randomly divided into three groups and administered with either 1ml/kg saline or 80 g/kg OT or 160 g/kg OT intraperitoneally for four weeks. Then, EMG, motor function test, biochemical analysis (plasma lipid peroxides and glutathione), histological, and immunohistochemical analysis of sciatic nerves (bax, caspase 3, caspase 9, and NGF) were performed. Results: Diabetic rats developed neuropathy, which was apparent from decreased compound muscle action potentials amplitudes and prolonged distal latency in saline-treated rats (p

WOS: 000388326300001, PubMed: 27401586, Background: Drug resistance development is an expected problem during treatment with protease inhibitors (PIs), this is largely due to the fact that Pls are low-genetic barrier drugs. Resistance-associated variants (RAVs) however may also occur naturally, and prior to treatment with Pls, the clinical impact of this basal resistance remains unknown. In Turkey, there is yet to be an investigation into the hepatitis C (HCV) drug associated resistance to oral antivirals. Materials and methods: 178 antiviral-naive patients infected with HCV genotype 1 were selected from 27 clinical centers of various geographical regions in Turkey and included in the current study. The basal NS3 Pls resistance mutations of these patients were analyzed. Results: In 33 (18.5%) of the patients included in the study, at least one mutation pattern that can cause drug resistance was identified. The most frequently detected mutation pattern was T54S while R109K was the second most frequently detected. Following a more general examination of the patients studied, telaprevir (TVR) resistance in 27 patients (15.2%), boceprevir (BOC) resistance in 26 (14.6%) patients, simeprevir (SMV) resistance in 11 (6.2%) patients and faldaprevir resistance in 13 (7.3%) patients were detected. Our investigation also revealed that rebound developed in the presence of a Q80K mutation and amongst two V55A mutations following treatment with TVR, while no response to treatment was detected in a patient with a R55K mutation. Conclusion: We are of the opinion that drug resistance analyses can be beneficial and necessary in revealing which variants are responsible for pre-treatment natural resistance and which mutations are responsible for the viral breakthrough that may develop during the treatment. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases., Department of Scientific Research Project of Kocaeli University; Turkish Society of Clinic Microbiology and Infectious Diseases, This study was funded by Department of Scientific Research Project of Kocaeli University and Turkish Society of Clinic Microbiology and Infectious Diseases.

Hizli, Omer/0000-0001-6822-2679 WOS: 000380913900011 PubMed: 27067155 Background: Pena-Shokeir syndrome type I is a rare genetic disorder that includes multiple congenital facial and joint anomalies as well as pulmonary hypoplasia. Affected infants are usually premature, and 30% of them are stillborn. So far, studies have reported low-set ears in such infants, with no middle or inner ear findings. Method: Histopathological study of human temporal bones with Pena-Shokeir syndrome type I. Results: Our case report describes an infant with severely decreased number of spiral ganglion cells and number of outer and inner hair cells of the cochlea, mild loss of vestibular hair cells, hypoplasia in the facial nerves, and ischemic degeneration of Schwann cells in the modiolus. Conclusion: Pena-Shokeir syndrome type I is associated with a degenerative process in the labyrinth. National Institute on Deafness and Other Communication Disorders (NIDCD)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Deafness & Other Communication Disorders (NIDCD) [U24 DC011968-01]; International Hearing Foundation; Starkey Hearing Foundation; 5M Lions International; Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was supported by the National Institute on Deafness and Other Communication Disorders (NIDCD), grant number U24 DC011968-01; the International Hearing Foundation; the Starkey Hearing Foundation; the 5M Lions International; and the Scientific and Technological Research Council of Turkey (TUBITAK).

Hizli, Omer/0000-0001-6822-2679 WOS: 000370500900001 PubMed: 26669555 Hypothesis: To compare histopathologic findings in the cochlea of human temporal bones with versus without intralabyrinthine hemorrhage. Background: Hemorrhagic labyrinthitis can cause sensorineural damage, sudden hearing loss, and vertigo. Yet, to our knowledge, no studies have quantitatively described histopathologic effects of intralabyrinthine hemorrhage on the elements of the cochlea. Methods: We analyzed 46 human temporal bone samples from 23 patients with unilateral intralabyrinthine hemorrhage (23 samples from ears with intralabyrinthine hemorrhage and 23 samples from contralateral ears without). We noted the location of hemorrhage in the inner ear, the degree of endolymphatic hydrops, the number of spiral ganglion cells and hair cells, mean loss of fibrocytes in spiral ligament, and areas of the stria vascularis and spiral ligament. Results: Intralabyrinthine hemorrhage caused significant loss of outer hair cells in the lower basal (p = 0.001), upper basal (p = 0.005), and lower middle (p = 0.012) cochlear turns. The degree of endolymphatic hydrops was significantly different between the hemorrhagic and contralateral sides (p = 0.011). But we found no significant difference between the 2 sides in the number of inner hair cells, spiral ganglion cells, and fibrocytes, or in the areas of the stria vascularis and spiral ligament between the two groups (p > 0.05). Conclusion: These findings suggest that such patients could be good candidates for hearing aid or cochlear implant if they have profound sensorineural hearing loss. National Institute on Deafness and Other Communication Disorders (NIDCD)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Deafness & Other Communication Disorders (NIDCD) [U24 DC011968-01]; International Hearing Foundation; Starkey Hearing Foundation; 5M Lions International; Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) This project was funded by the National Institute on Deafness and Other Communication Disorders (NIDCD), grant number U24 DC011968-01; the International Hearing Foundation; the Starkey Hearing Foundation; the 5M Lions International; and the Scientific and Technological Research Council of Turkey (TUBITAK). This study was accepted for presentation as a poster at the 2015 AAO-HNSF Annual Meeting and OTO EXPO, September 27-30, 2015, Dallas, Texas.

COVID-19 pneumonia misdiagnosed as pulmonary contusion in a child

PubMed ID: 30059131 Abstract Objective: To date, there is no consensus on the selection of type and size of prosthetic valve for aortic valve replacement (AVR). The aim of this study was to compare anatomical and functional changes occurring in the left ventricle after AVR with different sizes of mechanical valves. Methods: A total of 92 patients with serious aortic valve stenosis, who underwent AVR between March 2001 and June 2008 using mechanical valves of different sizes, were retrospectively analysed. The sizes of the mechanical valves were 19, 21, 23 and 25 mm. All patients were assessed pre-operatively, and at six months and in the first, third and fifth years postoperatively. The left ventricle was assessed with electrocardiography, echocardiography and telecardiography and compared in the four patient groups, constituted according to the mechanical valve size used. Results: In all groups, left ventricular mass and mass index, transvalvular aortic gradient, thicknesses of the interventricular septum and posterior wall, and left ventricular end-systolic and end-diastolic diameters had decreased significantly post surgery. Left ventricular ejection fraction and exercise capacity had increased significantly (p < 0.001). The most noteworthy anatomical and functional improvements were seen in patients who had received 23- and 25-mm mechanical valves. Conclusion: Mechanical valve replacement should not be performed with small size valves because of the higher residual gradient. © 2018 Clinics Cardive Publishing (PTY)Ltd. All Rights Reserved.

WOS: 000456751500018 PubMed: 30584976 Objectives: The hippocampus is susceptible to damage in patients with epilepsy and in animals with seizures caused by excitotoxic agents. The effect of vitamin D on hippocampal apoptosis related with seizures has not been reported. However, epileptic patients have an increased risk of hypovitaminosis D which is most likely due to the effects of antiepileptic drugs. Therefore, in this study, it was aimed to evaluate the effects of vitamin D on hippocampal apoptosis related with seizures by using pentylenetetrazol (PTZ) and kainic acid (KA) in rats. Methods: Male Sprague Dawley rats, aged 5.5 weeks, were randomly divided into six groups: control, vitamin D, PTZ, KA, PTZ + vitamin D and KA + vitamin D groups. The groups that received vitamin D were given 500 IU/kg of vitamin D daily for two weeks in addition to a standard diet. At the end of this period, PTZ and KA were applied to trigger seizures in the rats in the seizure groups. 24 h after the administration of PTZ and KA, the rats were decapitated. In the hippocampal region, apoptosis was assessed by TUNEL and brain-derived neurotrophic factor (BDNF), Bax, caspase-3 and c-fos activation were evaluated by immunohistochemical method. Results: BDNF level increased while c-fos, Bax and caspase-3 levels decreased (p < 0.0001, in all) in the hippocampal neurons of the groups that were pre-treated with vitamin D before the administration of PTZ and KA, in comparison with the PTZ and KA groups. Vitamin D significantly decreased the number of apoptotic cells in these rats in comparison with the PTZ and KA groups (p < 0.0001). Conclusion: This study indicates that vitamin D has neuroprotective effects on hippocampal apoptosis induced by PTZ and KA in rats. With this study it is suggested that keeping vitamin D levels within normal limits may be beneficial for patients with epilepsy, especially children. Research Fund of the Karadeniz Technical University [5384] This study was financially supported by Research Fund of the Karadeniz Technical University (Project Number: 5384).

WOS: 000462811400003 PubMed: 30932423 Objective: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. Material and methods: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. Results: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). Conclusions: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma.

demirdal, tuna/0000-0002-9046-5666 WOS: 000440301200015 PubMed: 30249562 Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest (R), aspartate aminotransferase-to-platelet ratio index(A-PRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further. Roche PharmaceuticalsRoche Holding [ML21920] This study was financially supported by Roche Pharmaceuticals (Protocol No: ML21920).

Gunal, Ozgur/0000-0002-7744-4123 WOS: 000458284300019 PubMed: 30478788 Mortality rates of Crimean-Congo hemorrhagic fever (CCHF) vary from 5% to 80%. However, there is no clear information available about why this disease is fatal for some people while others recover. In this study, the factors related to fatalities and serious clinical progression of CCHF patients and the correlation between serious prognosis and IL 28-B gene polymorphism were investigated. The study included 107 patients with a preliminary diagnosis of CCHF, and the patients were found positive for CCHFV RNA based on polymerase chain reaction (PCR) analysis. The IL 28-B rs12979860 polymorphism was identified by PCR restriction fragment length polymorphism (PCR-RFLP) analysis using blood samples from the patients. In addition to the IL 28-B analysis results, a variety of data along with laboratory records obtained during the hospital stay were evaluated using statistical analysis. Of the 107 cases, nine were fatal (8.4%), while the other patients recovered and were discharged. Twenty-four patients had the CC genotype (22.43%), 64 had the CT genotype (59.81%), and 19 had the TT genotype (17.76%). Of the nine patients who died, three had the CC genotype (33.33%) and six had the CT genotype (66.67%). None of the patients who died had the TT genotype. Symptoms and findings of diarrhea, abdominal pain, hemorrhage, and rash were more common in fatal cases than in non-fatal cases. The IL 28-B rs12979860 polymorphism was not found to have a statistically significant correlation with fatality or symptoms indicating serious clinical progression in CCHF patients. As has been observed in previous studies, our study showed that leukocytosis, abdominal pain and diarrhea were more common in fatal cases.

WOS: 000450087200005 PubMed: 28328695 Methylphenidate is a stimulant drug commonly prescribed to individuals with attention-deficit/hyperactivity disorder. The suggested underlying mechanism of acute dyskinesias is dopaminergic transmission increase. We describe a 9-year-old boy with a diagnosis of attention-deficit/hyperactivity disorder admitted to emergency clinic with primarily orofacial and extremity dyskinesia after administration of a first dose of 18 mg OROS (osmotic [controlled] release oral) methylphenidate (Concerta). OROS methylphenidate was discontinued, and the patient's symptoms resolved within 20 minutes after injection of biperiden by intravenous route (0.04 mg/kg). We wish to emphasize that acute orofacial dyskinesia and extremity dyskinesia can be observed during methylphenidate therapy and that biperiden can be successfully used in the treatment of this unpleasant condition. To the best of our knowledge, this is the first report of the use of biperiden therapy in this condition. This case report highlights the importance for physicians of awareness of dyskinesia as a potential adverse effect of methylphenidate therapy and indicates benefit of biperiden therapy.

Gunal, Ozgur/0000-0002-7744-4123; Sari, Tugba/0000-0003-3204-2371 WOS: 000453639300003 PubMed: 29962486 Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease. We aimed to investigate the cutaneous manifestations of CCHF and reveal their associations with fatality. Two hundred and sixty-nine patients diagnosed with CCHF were assessed. Skin findings were observed in 170 (63.2%) patients. A facial rash was the most common cutaneous finding (n = 82, 30.5%). In severe cases, hemorrhagic cutaneous manifestations (petechiae and ecchymoses) were recognized. A statistically significant correlation was obtained between cutaneous manifestations and fatality, and it was determined that there was a strong positive correlation between fatality and ecchymosis (r = 567, p < 0.001). In addition, a logistic regression analysis was performed, and death occurred 4.69 times more in those with skin signs than in those without. We hypothesize that CCHF patients with ecchymosis are at the highest risk and that cutaneous findings can contribute to the prognosis of CCHF.

WOS: 000424734200021 PubMed: 29413060 This experimental study was carried out using a pre-test/post-test control group model to evaluate the effect of a "Brief Cognitive Behavioural Stress Management Programme" (BCBSMP) on mental status, coping with stress attitude, and caregiver burden while caring for patients with schizophrenia. A total of 61 caregivers who provided care for schizophrenia patients at a community mental health centre were included in the study. Caregivers were matched according to gender and scale scores and were assigned to either the study or the control group. Before and after the programme, caregivers in both groups were given the "Demografic Data Form", "Zarit Caregiver Burden Scale", "Coping Attitude Evaluation Scale", "Stress Indicators Scale", and the "General Health Survey-28". Caregivers in the study group were taken to a BCSMP one session per week (each session lasted 120 min) for seven weeks. We determined that the stress indicators, the risk of developing a psychological disorder, and caregiver burden decreased and skills related to both the problem-oriented and emotion-oriented aspects of stress increased in the study group after the programme.

WOS: 000372954900014 PubMed: 28092191 Background and aims: In this study, the Internet Addiction Test (IAT) was adapted to Turkish language, which was originally developed by Young (1998) in English to measure the presence and severity of the Internet dependency. The main purpose was to ensure that the psychometric features and the factor structure of the test were suitable for Turkish university students. Method: The study was conducted in two sequent phases. Participants were 990 undergraduate students from several public universities in Turkey. Results: In the first phase, an exploratory factor analysis (EFA) was applied to figure out the factor structure of the Turkish version of the IAT. The EFA revealed four factors, which explained 46.02% of the total variance. In the following phase, a confirmatory factor analysis (CFA) was conducted with a different sample, to verify the factor structure that was found in the initial EFA. The CFA resulted four-factor model was satisfactory for the Turkish version of the IAT. These four factors were named as Mood, Relationship, Responsibilities, and Duration. Conclusions: Based on the findings, the administration of Turkish version of the IAT provided acceptable results on undergraduate students.

Monsanto, Rafael/0000-0002-9124-593X; Hizli, Omer/0000-0001-6822-2679; da Costa Monsanto, Rafael/0000-0002-9124-593X; (Bingol) Hizli, Pelin/0000-0001-8919-3125 WOS: 000381264100021 PubMed: 26573155 To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused on hydropic changes; so far, no such studies have investigated peripheral vestibular otopathology using differential interference contrast microscopy, in patients with syphilis. For this study, we examined 13 human temporal bone samples from 8 patients with a history of syphilis. Using conventional light microscopy, we performed qualitative histopathologic assessment. In addition, using differential interference contrast microscopy, we performed type I and type II vestibular hair cell counts on each vestibular sense organ with minimal autolysis; in which the neuroepithelium was oriented perpendicular to the plane of section. We then compared vestibular hair cell densities (cells per 0.01 mmA(2) surface area) in the syphilis group vs. the control group. In the syphilis group, we observed precipitate in the endolymphatic or perilymphatic spaces in 1 (7.7 %) of the samples and endolymphatic hydrops in eight (61.5 %) of the samples. Hydrops involved the cochlea (four samples) and/or saccule (four samples). In addition, the syphilis group experienced a significant loss of type II vestibular hair cells in the maculae of the utricle and saccule, and in the cristae of the lateral and posterior semicircular canals, as compared with the control group (P < 0.05). NIH (NIDCD)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Deafness & Other Communication Disorders (NIDCD) [U24 DC011968-01]; International Hearing Foundation; Starkey Hearing Foundation; 5M Lions International; Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) This project was funded by NIH (NIDCD), Grant number U24 DC011968-01; the International Hearing Foundation; the Starkey Hearing Foundation; and the 5M Lions International. Omer Hizli and Serdar Kaya received the Scientific and Technological Research Council of Turkey (TUBITAK) Scholarship

PubMed ID: 26129972, Background: A. baumannii is an important nosocomial pathogen associated with high mortality, morbidity and medical cost. Aim: The aim of this study was to investigate risk factors for MDR A. baumannii bacteremia and also evaluate cost of hospitalization of these patients. Methods: Study was conducted in Ankara Atatürk Training and Research Hospital. Patients who were hospitalized in ICU and diagnosed for nosocomial blood stream infection (BSI) between January 2007 and December 2010 were checked retrospectively. Patients with nosocomial BSI caused by multidrug resistant A. baumannii were compared with the patients who had BSI caused by other Gram-negative microorganisms in terms of risk factors, mortality and medical costs. Findings: In multivariate analysis previous use of carbapenem, quinolone and metronidazole, and SAPS II score were found as independent risk factors. In case group; immunosupression, SAPS II score, and hospital stay until infection were independently associated with mortality in multivariate analysis. Conclusion: Our results suggest that the occurrence of MDR A.baumannii bacteremia was related with the usage of the wide spectrum antibiotics, and mortality rates were increased in patients that high SAPS II scores, long term hospitalization. Infection control procedures and limited antibiotic usage are very important for prevent nosocomial infections. © 2015 The Authors.

WOS: 000361339400008, PubMed: 26067745, Objective: To determine the impact of percutaneous nephrolithotomy (PNL) on global and regional renal function in children. Methods: In total, 40 children (41 renal units) undergoing PNL were included in this prospective study. All patients were evaluated using quantitative single-photon emission computed tomography (QSPECT) with technetium-99 m-dimercaptosuccinic acid (Tc-99m-DMSA) examinations before and 3 months after surgery. Results: The mean age was 9.5 years (range, 3-16), and the mean stone size was 3.4 cm (range, 2-6.5). Of the cases, 39 (95%) were managed as being stone-free after a single session of PNL. After additional treatment procedures, 40 (97.5%) of the cases were managed as being stone-free. Of the 41 renal units, new focal cortical defects on Tc-99m-DMSA scans were seen in 4 (9.7%) patients. Total relative uptake in the treated kidneys increased from 42.3% to 44.1%. The mean creatinine level before PNL was 1.18 +/- 0.45 (0.8-1.6) mg/dL compared with 1.16 (0.7-1.5) mg/dL by the end of the follow-up period (not statistically significantly different, p>0.05). Conclusions: PNL in children is a safe and feasible method for the maximal clearance of stones. QSPECT of Tc-99m-DMSA confirmed that renal function is preserved or even improved after percutaneous stone removal.

WOS: 000354157700016 PubMed: 25772252 Background: Serum fibroblast growth factor 23 (FGF-23) and fetuin-A are established predictors of morbidity and mortality due to cardiovascular disease. The objective of the present study is to evaluate the relationship between coronary artery disease (CAD) and serum concentrations of FGF-23 and fetuin-A. Methods: A total of 383 subjects who underwent coronary computed tomography angiography (CCTA) were included in the study. CCTA detected CAD in 208 patients; the rest of the patients had no detectable CAD. Results: Serum FGF-23 and fetuin-A levels were significantly increased in CAD patients compared to non-CAD patients (26.6 +/- 21.1 pg/mL vs. 17.9 +/- 16.1 pg/mL, p = 0.001 and 826 +/- 350 mg/L vs. 595 +/- 300 mg/L, p < 0.001, respectively). Serum FGF-23, fetuin-A, low-density lipoprotein (LDL)-cholesterol, and uric acid values were elevated in non-diabetic patients with CAD when compared to those without CAD. FGF-23, and fetuin-A were not significantly different in diabetic patients with CAD when compared to those without CAD. Using multivariate logistic regression analysis, we found that age, hypertension, LDL-Cholesterol, highdensity lipoprotein (HDL)-Cholesterol, hs-CRP, uric acid, FGF-23 and fetuin-A levels were independently associated with the presence of CAD. Conclusion: FGF-23 and fetuin-A were positively correlated with coronary atherosclerosis Similar trends were seen among diabetic patients, but this did not reach statistical significance. FGF-23 and fetuin-A could be used as novel risk markers of cardiovascular disease. (C) 2015 Elsevier Inc. All rights reserved. Mugla Saki Kocman UniversityMugla Sitki Kocman University Mugla Saki Kocman University.

Purpose: To investigate whether or not the age of spontaneous resolution of monosymptomatic nocturnal enuresis (MNE) was familial. Patients and Methods: A questionnaire was administered to more than 1,500 people, and 100 appropriate participants were identified from four referral hospitals. We included the participants who had MNE and whose parents also had MNE with spontaneous resolution. Then the association between the spontaneous resolution time of MNE in parents and that in their children was investigated. Results: The mean ages of spontaneous resolution were 10.7 (10-30 years), 9.4 (6-17 years) and 10.9 (6-18 years) in participants, their mothers and their fathers, respectively. According to the statistical analysis, there was a positive correlation between participants and both their mothers and fathers (p < 0.05). In addition, it was revealed that familial MNE history based on first- and second-degree relatives, in addition to their parents, was also associated with the increased spontaneous resolution age of MNE (p < 0.05). According to our results, gender and parents' education status were not statistically associated with the spontaneous resolution (p > 0.05). Conclusion: As a conclusion, the age of spontaneous resolution of MNE is familial. Although the exact reasons of spontaneous resolution still remain a mystery; further genetic investigations may be able to resolve this mystery.

WOS: 000440545900004 PubMed: 29633793 Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

Ozcan, Kursat Murat/0000-0002-5262-0565 WOS: 000404962700020 PubMed: 28665845 Objective:We aimed to investigate the effect of anterior palatoplasty (AP) plus modified expansion sphincter pharyngoplasty (MESP) on voice performance in patients with obstructive sleep apnea syndrome (OSAS).Methods:Fourteen OSAS patients who had AP+MESP procedure were included in the study. Voice performances of the patients were analyzed with acoustic voice analysis before surgery, and 6 months after surgery.Results:Preoperative and postoperative F0, jitter percentage, and shimmer percentage were compared. Mean preoperative F0 was 129.85Hz, and mean postoperative F0 was 138.07Hz, with a significant difference in between (P=0.017). Mean preoperative jitter percentage was 0.65, and mean shimmer percentage was 0.88, while those values were 0.67 and 0.84, respectively, in the postoperative period. The differences were not statistically significant (P=0.801 and 0.652).Conclusion:The AP+MESP procedure performed for OSAS results in improvement of F0 in the long term; however, there were no differences in jitter percentage and shimmer percentage.

WOS: 000399239600015 PubMed: 27896502 It is known that fathers whose infants are hospitalized in NICUs (Neonatal Intensive Care Units) are severely stressed. This study was conducted for the purpose of determining the effect of supporting and visiting infants in NICUs on stress levels of Turkish fathers. This was a pretest-posttest quasi-experimental study. The population of the study consisted of 47 fathers who had their infants receiving treatment in NICU at a state hospital in the eastern Turkey and agreed to participate in the study. The data were collected by using "Father-Infant Introductory Information Form" and "Parental Stressor Scale: Neonatal Intensive Care Unit, PSS:NICU". When comparing the PSS:NICU total mean scores of the fathers before and after interventions; it was determined that their mean scores were higher before visits compared to those obtained after interventions and the difference between them was significant at advanced level. It was found that the fathers visiting and supporting their infants in NICUs had the decreased stress levels. It is a useful nursing intervention to support fathers to visit their babies in NICUs and establish environments where they could spend time with their babies.

okan, vahap/0000-0002-9869-8181; Sahin, Handan Haydaroglu/0000-0002-3467-8819; Oguzkan Balci, Sibel/0000-0003-0537-3028 WOS: 000394527000002 PubMed: 27611810 In this study, we aimed to explore the association among gene variants of five cytokines, tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta-1 (TGF-beta 1), interferon gamma (IFN-gamma), interleukin-6 (IL-6), and interleukin-10 (IL-10), and clinical parameters and prognosis in patients with multiple myeloma (MM) treated with novel therapeutic drugs in Turkish population for the first time except TNF-alpha. We analyzed five cytokine genes in 113 cases with MM and 113 healthy controls. Cytokine genotyping was performed by the polymerase chain reaction-sequence-specific primer method (PCR-SSP). AG genotype associated with high expression in TNF-alpha gene (-308) variant was found to be significantly higher (p = 0.019), and GG genotype associated with low expression in TNF-alpha gene (-308) variant was significantly lower in MM group as compared with controls (p = 0.012). IFN-gamma (+874) variant TT genotype was increased (p = 0.037), and AA genotype was decreased (p = 0.002) in MM group in contrast to controls. IFN-gamma (+874) T allele was higher inMMpatients compared with controls (OR = 1.985, p = 0.000), while A allele was significantly lower (OR = 0.5037, p = 0.0005). Multivariate analysis revealed that factors associated with 5-year overall survival (OS) were only IPI III (RR = 1.630, p = 0.018) and thrombocytopenia (RR = 2.207, Cox p = 0.021), while 5-year event-free survival (EFS) was associated with IPI III (RR = 1.524, p = 0.022), thrombocytopenia (RR = 2.902, p = 0.002), APSCT treatment (RR = 1.729, p = 0.035), and female gender (RR = 0.435, p = 0.002) with negative prognostic values. Our results suggested that TNF-alpha gene (-308) AG genotype and IFN-gamma (+874) TT genotype and T allele may have a role on MM, while other cytokines were not associated with the risk of MM.

kekilli, murat/0000-0002-3063-8748; Wahlin, Staffan/0000-0002-5985-9464 WOS: 000347692700011 PubMed: 25495215 Background. Despite advances in the understanding of the pathophysiological basis of autoimmune hepatitis (AIH), it is still difficult to delineate the mechanisms involved in progression from hepatic inflammation toward fibrosis. Our aim was to study serum concentrations of NO in AIH of different histological severity and possible effects of immunosuppressive therapy on NO production. Materials and methods. We studied serum NO metabolites (NOx) in 47 consecutive patients with AIH and in 28 age-and sex-matched controls. Results. Serum NOx concentrations were higher in AIH patients than in controls (10.3 (4.5-27.3 mu mol/L) vs. 4.3 (1.6-14.3 mu mol/L), p < 0.001). According to liver histology, median NOx concentrations were significantly higher in patients with severe interface hepatitis compared to patients with mild-moderate interface hepatitis (12.3 (4.5-27.3 mu mol/L) vs. 9.3 (4.6-20.3 mu mol/L), p = 0.029). Similarly, serum NOx concentrations were significantly higher in patients with advanced fibrosis than in those with early fibrosis (12.2 (4.6-27.3 mu mol/L) vs. 9.3 (6.6-12.8 mu mol/L), p = 0.018). NOx concentrations decreased in 16 AIH patients who were tested also after biochemical remission was achieved (12.6 (4.5-22.8 mu mol/L) at baseline and 5.9 (2.8-10.5 mu mol/L) after remission, p = 0.001). Conclusion. This study shows that serum NOx levels are associated with the histological severity of AIH. Hepatocyte inflammation and injury may activate hepatic stellate cells and kupffer cells, and the consequences may include release of NO, which ultimately promotes hepatic fibrosis. Immunosuppressive therapy inhibits this process and the production of NO.

Objective: To compare the safety and efficacy of en bloc stapling and separate ligation techniques for renal vascular control during laparoscopic nephrectomy. Patients and Methods: Clinical data were collected from 60 patients who underwent laparoscopic nephrectomies using en bloc stapling (n = 27, group 1) or the separate ligation method (n = 33, group 2). Comparative analysis was carried out between the two groups, examining operative times, blood loss, intra- and postoperative complications and hospital stay. Results: Compared with the separate ligation method, the en bloc hilar control technique was associated with a shorter total operating time (98 vs. 121 min, p = 0.029). However, both groups were similar in terms of estimated blood loss, hemoglobin drop, changes in creatinine level and postoperative hospital stay. The total complication rates in group 1 and 2 were 3.7 and 15.1%, respectively, with a statistically significant difference. There were no complications related to the use of the endo-GIA stapler and no patients required conversion to open surgery in group 1. In group 2, 2 patients required conversion to open surgery, including 1 due to renal vein bleeding secondary to inaccurate vascular control and the other due to bleeding from the vena cava during dissection. In addition, 1 patient had a superficial bowel injury that was repaired laparoscopically and another had a superficial liver tear that was managed without conversion or transfusion. Conclusion: En bloc ligation of the renal hilum is an easy and reliable technique that allows safe and fast control of the renal pedicle.

Objective: Snoring is a sound caused by vibration of collapsed and/or unsteady airway walls of the pharynx and soft palate. We compared stored spectra of snoring sounds recorded via cell phone (CP) and a microphone placed over the head (head phone [HP]). Methods: Thirty-four snoring patients were included in this prospective study. Groups were identified by reference to body mass index (BMI) values: group 1, BMI < 25 kg/m2 (n = 8); group 2, BMI 25 to 29 kg/m2 (n = 10); and group 3, BMI ≥ 30 kg/m2 (n = 16). Snoring sounds were recorded using CPs and HPs and digitally analyzed. We identified the frequencies with the highest snoring powers (Fmax values) and snoring sound intensity levels (SSILs). Results: Fmax ranged from 520 to 985 Hz in HP recordings and from 845 to 1645 Hz in CP recordings. Snoring sound intensity level values increased in proportion to BMI and were 6 to 24 dB in HP recordings and 19 to 52 dB in CP recordings. Thus, the CP values of Fmax and SSIL were higher than the HP values. In obese patients of group 3, almost all Fmax and SSIL values were higher than those of groups 1 and 2. In particular, the CP Fmax values were elevated in such patients. The advanced technologies used in modern CPs may allow some snoring sounds in susceptible individuals to be defined as oronasal. Conclusion: Cell phone technology allows snoring to be evaluated in patients located in areas remote from a hospital. To explore the intensity of snoring and to postoperatively monitor the efficacy of surgery used to treat snoring, telephonic sound analysis is both new and effective and reduces the need for patient attendance at a hospital. Those experiencing severe snoring and/or who are obese should be told of what can be done to solve such problems.

WOS: 000334479400010 PubMed: 24650385 Objectives: This study aims to perform an experimental examination of the patellar tendon grafts repaired using an interference screw and free tendon graft. Material and methods: Twelve knees of the lower limbs which were amputated due to circulatory disease were included in this study. The knees were removed from all soft tissues including patellar tendons. A tendon graft was fixed onto tuberositas tibia through the distal portion of the knee using an interference screw. The patellar tendon graft and tuberositas tibia complex were fixed at the lower and upper part of the testing machine. The distraction force of the bone-tendon-bone complex was recorded using the testing machine. Results: Both patellar and tibial ruptures were detected. The pullout force of the tendons was found to be 810 at maximum and 420 N at minimum. The mean pullout force was 600 N in men and 525 N in women with an overall mean of 575 N. Conclusion: Our study results showed that patellar tendon repair with grafting had a similar pullout force compared to other repair techniques. In case of a neglected rupture of the patellar tendon, in particular, grafting is recommended.