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Background: Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by microangiopathy, inflammation, fibrosis. Interstitial lung disease (ILD) is common among SSc patients. Objective: This study aims to define the clinical, laboratory, and serologic characteristics of SSc patients with ILD and to present the frequency of chest computed tomography features. Methods: Two hundred twenty-six SSc patients who applied to the Rheumatology Department between January 2007 and August 2019 were retrospectively examined. A total of 100 SSc patients with ILD (44.2%) were determined. Clinical, laboratory, and serological features of SSc patients with and without ILD were compared. Results : Both groups had similar characteristics in terms of age and sex. The duration of disease (p=0.001) and follow-up time (p=0.001) were longer in SSc patients with ILD. Multivariable logistic regression analysis indicated that the duration of disease (OR: 1.06 (1.01-1.13), p=0.029), presence of gastrointestinal system involvement (OR: 3.29 (1.28-8.46), p=0.013) and anti-SCL70-positivity (OR: 6.04 (2.35-15.49), p Conclusion: We have shown a relationship between anti-SCL70, disease duration, gastrointestinal system involvement, and ILD in SSc patients.

Background and objectives Patients undergoing radical prostatectomy are at increased risk of Acute Kidney Injury (AKI) because of intraoperative bleeding, obstructive uropathy, and older age. Neutrophil Gelatinase-Associated Lipocalin (NGAL) may become important for diagnosis of postoperative AKI after urogenital oncosurgery. The objective of this study was to evaluate and compare the efficacy of NGAL as a predictor of AKI diagnosis in patients who underwent Retropubic Radical Prostatectomy (RRP) and Robot-Assisted Laparoscopic Prostatectomy (RALP) for prostate cancer. Methods We included 66 patients who underwent RRP (n = 32) or RALP (n = 34) in this prospective, comparative, nonrandomized study. Patients’ demographic data, duration of surgery and anesthesia, amount of blood products, vasopressor therapy, intraoperative blood loss, fluid administration, length of hospital stay, creatinine, and plasma NGAL levels were recorded. Results Intraoperative blood loss, crystalloid fluid administration, and length of hospital stay were significantly shorter in RALP. There was no statistically significant difference between the groups in terms of intraoperative blood transfusion. Postoperative creatinine and plasma NGAL levels were increased in both groups. The 6-h NGAL levels were higher in RRP (p = 0.026). The incidence of AKI was 28.12% in RRP and 26.05% in RALP, respectively. The NGAL level at 6 hours was more sensitive in the early diagnosis of AKI in RALP. Conclusion Although postoperative serum NGAL levels were increased in both RRP and RALP, the 6-h NGAL levels were higher in RRP. RALP was associated with fewer intraoperative blood loss and fluid administration, and shorter length of hospital stay.

The most important drug metabolizing enzyme of the detoxification mechanism is known as Glutathione S-Transferase. GST enzymes may be associated with brain tumor epidemiology, clinical and demographic factors. The correlation between parameters such as changes in Glutathione S-transferase Theta1 proteins, tumor localizations, age, gender, alcohol use, smoking, chemotherapeutic/radiotherapeutic treatment status in normal and brain tumor tissues, diagnosed in neurosurgery department, were examined by immunohistochemistry. GST-Theta1 expressions were analyzed using immunostaining in samples from 149 patients diagnosed with brain tumors between 2016 and 2018. The mean age of the patient group was 49.44 years. 83 (58.45%) patients were male. After immunohistochemical staining, GST-T1 expression was found approximately 9,46 times higher in tumor tissues than in normal tissues (p

Background: The coexistence of a hydatidiform mole and a fetus can occur in a multiple pregnancy, being less frequent in triplets and quadruplets because of their infrequency. With assisted reproduction, multiple pregnancies are becoming more frequent, and we can expect more frequent coexistence with a molar pregnancy. Case report: This G3, P1 30-year-old mother, after assisted conception, was diagnosed with a quadruplet pregnancy, one of which was a molar conceptus. Due to the potential for malignancy, the pregnancy was electively terminated. Conclusion: Despite the difficulty in conceiving, elective termination of a multiple pregnancy associated with a molar pregnancy may be the most judicious course of action to protect the mother's life.

Aort diseksiyonu nadir görülen genellikle hipertansif ve bağ doku hastalıkları ile ilişkili bir vasküler hastalık olup mortalite oranları yüksektir. Gebelik de aort diseksiyonu için bir risk faktörüdür ve tedavisi acil cerrahi müdahaledir. Gebelik sırasında aort diseksiyonuna nadiren rastlanır ve tedavisiz kalması halinde ölümle sonuçlanabilir. Ancak gebelik öncesinde aort diseksiyonu geçirip opere olan ve sonra gebe kalan hastaların gebelik takibi ile ilgili literatürde yeterli veri yoktur. Bu çalışmada Tip A aort diseksiyonu sonrasında suprakoroner ve hemiark aort sentetik greft replasman öyküsü olan ve 15 haftalık gebeliği sırasında toraks bilgisayarlı tomografisinde (BT) asendan aortta aortik, anulus düzeyinde 60x56mm fuziform anevrizmatik dilatasyon, desenden aortta proksimal kesimi 55mm, orta kesim 68 mm ve distal kesimi 45mm boyutlarında belirgin fuziform anevrizma saptanmıştır. Hastanın aynı zamanda epilepsi ve astım öyküsü mevcuttur. Mevcut medikal durumu ve komorbiditeleri sebebiyle kardiyoloji, kalp damar cerrahisi ve perinatolojinin içinde bulunduğu bir konsey kararı ile hastaya gebeliğin yüksek riskli olduğu bildirilmiştir. Hastanın terminasyon istemi olması üzerine 3 saat aralıklarla 400 mcg vajinal prostoglandin E1 uygulanmıştır. Ancak 12 saati geçmesine rağmen abortus gerçeklememesi üzerine dilatasyon amacıyla servikal balon yerleştirilmiş ve abortus sonrasında rest plasenta kalması üzerine hastaya Bumm-Küretaj yapılmıştır.

Our objective is to investigate maternal midtrimester plasma and amniotic fluid (AF) levels of angiopoietin-2 (Ang-2) and thrombomodulin (TM), which are involved in vascular remodelling and endothelium activation, in placental disorders including foetal growth restriction (FGR) and preeclampsia (PE). This prospective multiparametric pilot study was conducted at the Perinatology Division of Trakya University in a population undergoing genetic amniocentesis. Both AF and plasma aliquots were kept in -80 °C until ELISA assay. The pregnancies were followed up until the end of gestation in terms of obstetric results. Amniotic fluid and plasma aliquots from 127 pregnancies who underwent genetic amniocentesis between 16 and 24 weeks of gestation were analysed. During the final data evaluation, 39 were excluded with various reasons. Twelve subsequently developed FGR and 11 complicated with PE. The control group (n = 65) was consisted of women delivered >37th week with an uncomplicated outcome. The midtrimester maternal Ang-2 levels in both AF and plasma and also TM levels in plasma were found to be significantly increased in pregnancies who subsequently developed FGR or PE (p< .05). The midtrimester Ang-2, which rises in both plasma and AF and the midtrimester TM, which only significantly increase in plasma compartment in PE group, as compensatory mechanism may be the precursors of placental disorders including FGR and PE.Impact StatementWhat is already known on this subject? It is known that angiopoietin-2 (Ang-2) has important role in placental angiogenesis and vascular remodelling. TM which is a receptor for Ang-2 plays a protective role in pregnancy by preventing the uteroplacental circulation from thrombosis.What do the results of this study add? The present study demonstrates that both midtrimester maternal plasma Ang-2/TM and amniotic fluid (AF) Ang-2 levels were significantly higher in PE and FGR group than uncomplicated group. Midtrimester AF TM levels were not significantly higher in PE group than the control group.What the implications are of these findings for clinical practice and/or further research? In the clinical practice, high levels of midtrimester Ang-2 and TM in plasma may be used for the prediction of FGR and PE. Although amniocentesis is not practical in the clinical use, the levels of these two markers in both AF and plasma compartments may contribute to explain the pathophysiology of FGR and PE.

AIM High Mobility Group Box-1 (HMGB-1) is a nuclear protein acting as a proinflammatory molecule. The serum HMGB-1 levels were found elevated in chronic inflammatory diseases. In this cross-sectional study, serum HMGB-1 levels in Behcet's disease (BD) patients and healthy controls (HC) were studied. Also, its association with disease activity scores and clinical findings were evaluated. METHOD Ninety BD patients and 50 age-sex matched HC were included in the study. Disease activity scores were assessed by Behcet Disease Current Activity Form (BDCAF) and Behcet Syndrome Activity Score (BSAS). Serum HMGB-1 levels were measured using a commercial ELISA kit. A p-value of < 0.05 was considered to be statistically significant. RESULTS Serum HMGB-1 levels were significantly higher in BD than in HC (43.26 pg/mL and 16.73 pg/mL; p< 0.001 respectively). Serum HMGB-1 levels were statistically significantly associated with presence of erythema nodosum (EN) and genital ulcers in the last one month prior to recruitment (p= 0.041 and p< 0.001, respectively). BDCAF and BSAS scores were positively correlated with serum HMGB-1 level (p= 0.03 and p= 0.02, respectively). CONCLUSION HMGB-1 may play a role in the development of BD. Also, due to its positive correlation with disease activity indices, it can be used as a novel disease activity parameter in BD.

A fundamental goal in molecular oncology is to unravel the underlying mechanisms which cause the cell transformation. In line with this approach, genome-wide functional screening approaches have revealed exciting insights into heterogeneous nature of cancer. Rapidly expanding horizons of research have unraveled myriad of pathways which play instrumental role in carcinogenesis and metastasis. Oxidative stress has also been reported to be significantly involved in cancer onset and progression. In line with this approach, oxidative stress modulating chemicals have always been sharply divided into antioxidants and oxidative stress-inducing agents. Conceptual and experimental advancements have enabled us to critically analyze full potential of these two different groups of chemicals in cancer chemoprevention. Different antioxidants are currently being analyzed in different phases of clinical trials. Although it has been reported in the literature that antioxidant supplements reduce tumor cells in some tumors or cause volume reduction in solid tumor sizes, there is no definite consensus. Therefore, an antioxidant supplement guideline based on more detailed clinical research and as a result of these is needed to achieve the best care for cancer patients and to avoid risky treatments for cancer patients.

Antibiotic hypersensitivity reactions can lead to marked morbidity, mortality and inadequate treatment options. Mycobacterium abscessus infection is a difficult management system for clinicians since it most commonly involves the lungs, progresses if untreated, and the organism is resistant to many antibiotics, as well as the agents used in treatment can cause undesirable side effects. Although macrolides are one of the most reliable antibiotic groups in terms of allergic reactions, early type hypersensitivity reactions against macrolides, one of the main antibiotics used in the treatment of Mycobacterium abscessus lung disease, may make the treatment management of the disease difficult. Due to the rapid increase in the use of quinolone in recent years, the frequency of developing allergic reactions with these agents also increases. In cases where antibiotic hypersensitivity is detected, the use of the responsible agent should be avoided, but desensitization may be necessary in cases without different treatment options. In this study, it was aimed to present a case of successful desensitization with clarithromycin and moxifloxacin in a patient who was diagnosed with Mycobacterium abscessus lung disease and developed anaphylaxis with clarithromycin and moxifloxacin after treatment was initiated.

Background The aim of this study was to evaluate the role of histopathological and biochemical parameters in the prediction of the presence and number of PSMA positive lesions consistent with the metastatic spread of prostate cancer on Ga-68-PSMA PET images. Methods Biochemical, histopathological and imaging data of 302 prostate cancer patients who underwent Ga-68-PSMA-11 PET/CT or PET/MR imaging for primary staging were retrospectively analyzed. Patients were divided into two groups as "PET positive" and "PET negative" according to the presence of pathologic extraprostatic PSMA involvement. "PET positive" patients were additionally divided into two groups: oligometastatic (1-3 metastatic lesion) and multimetastatic (>3 metastatic lesions). Results The mean age of patients was 66.8 +/- 7.6 years. Imaging modality was PET/MR in 223 (73.8%) and PET/CT in 79 (26.2%) of patients. Total PSA, PSA density (PSAD), ALP, and tumor ratio in biopsy specimens were found to be significantly higher in "PET positive" group compared to "PET negative" group and in multimetastatic group compared to oligometastatic group. PET positivity was observed in 3.8% of the low-intermediate risk groups (ISUP 1-3 and total PSA 20 ng/ml or PSAD >= 0.15 ng/ml/cc) with a relative risk of 12 (p < .001). The prediction models to predict the PET positivity and the presence of distant metastasis had AUCs of 0.901 and 0.925, respectively; with ALP, total PSA, and tumor ratio in needle biopsy specimen as significant independent predictors (p < .05). Conclusions In this study, Ga-68-PSMA-11 PET positivity was significantly higher in the high-risk patient group than in the low-intermediate risk groups. The prediction models used for predicting the PET positivity and the presence of distant metastasis on PET imaging were successful with high discriminatory powers. In addition to total PSA and ISUP GG, ALP and tumor ratio in biopsy specimens can be used to identify high-risk patients.

Introduction :In inguinal hernia, standard procedure has been considered open repair for a long time, the number of pediatric surgeons who prefer laparoscopic techniques is increasing day by day. In this study, it was aimed to determine how pediatric surgeons in our country approach patients with inguinal hernia and manage the treatment process. Methods :Controversial issues on inguinal hernia repair were identified and a questionnaire was prepared to reveal the current situation. The questionnaire was delivered to members of Turkish Association of Pediatric Surgery on the official website of the association.Results :The survey was directed to 420 people, 92 people returned with the answers to the questionnaire. Thirty six of the surgeons prefer the laparoscopic method for inguinal hernia repair. The reason for choosing open surgery was questionned, the most frequent answer was to be more experienced and to have more cumulative knowledge on open repair method. According to survey, the greatest advantage of laparoscopy was stated to be the better evaluation of the contralateral inguinal canal (n=16, %44,4). Twelve of surgeons who performed laparoscopic treatment in the selection of patients stated that gender is important and prefer laparoscopic surgery for female patients. Thirty percent (n = 11) of the participants stated that they prefer laparoscopy in patients between 3 months and 13 years old, while the rest prefer laparoscopy at all ages. In conclusion thirty nine percent of surgeons in Turkey prefer laparoscopic repair. Open repair is stil preferred in our country. There is still no consensus on perfect method and patient selection yet.

Objective: Guidelines suggest using bronchial provocation testing (BPT), which is hard to attain, in patients with asthma-like symptoms presenting with nondiagnostic spirometric tests. To eliminate the risk of over/underdiagnosing asthma, we aimed to evaluate the predictive value of not only fractional exhaled nitric oxide (FeNO) but also other easily accessible clinical indices for ruling in/out asthma. Materials and Methods: This retrospective study included adults presenting to our clinic with respiratory symptoms suggestive of asthma but with normal spirometric values and negative reversibility test, who underwent FeNO and methacholine BPT (MchBPT). Medical records were used to obtain descriptive characteristics, clinical history, allergy screening, eosinophils in peripheral blood, and spirometry. Results: Among 51 patients, 19 were diagnosed with asthma. Body mass index and blood eosinophils were significantly higher in patients with positive MchBPT (p=0.042 and p=0.037, respectively). No significant difference was found in other indices, including FeNO (p=0.293). Receiver operating characteristic curve analysis revealed the best diagnostic cutoff level for FeNO as 14 ppb and blood eosinophil as 150/μl for the prediction of positive MchBPT (with 63.16%-62.5% and 80%-61% sensitivity-specificity, respectively). These two indices were the only independent predictors of positive BHR, and the model of FeNO>14ppb combined with eos>150/μl showed 100% specificity with a 100% negative predictive value. Conclusion: Our results suggest using the combination of FeNO with blood eosinophil count as a rule-out test, adding a new step in the algorithmic diagnosis of asthma. This might avoid an unnecessary BPT procedure, reduce the risk of over/under-diagnosis of asthma, and hasten the correct diagnosis.

Introduction:The most common surgical emergency in the paediatric group during the coronavirus disease-2019 (COVID-19) pandemic is appendicitis, as it was before. This study aimed to evaluate clinical differences of paediatric appendicitis cases and changes in the management strategy between the pandemic and non-pandemic period.Methods:Cases during the non-pandemic period (March-July 2019) and pandemic period (March-July 2020) were analysed. Demographic data, duration of symptoms, physical examination, laboratory and radiological findings, paediatric appendicitis score (PAS), operative techniques, medical treatment, complications and hospital stay were evaluated retrospectively.Results:This study enrolled 70 patients during the non-pandemic period and 48 patients during the pandemic period. Duration of symptoms was significantly prolonged (p

Objective Fetal growth is an important indicator of fetal health. Low birth weight (LBW) is also associated with increased perinatal morbidity and mortality. Numerous factors that affect fetal weight have been identified. In this study, we aimed to investigate the effect of body mass index, smoking, and anemia on fetal birth weight on term pregnant women who had vaginal delivery in our clinic. Methods This study is a retrospective cross-sectional study. This study included patients who had a spontaneous vaginal delivery at our hospital between January 1st, 2018, and June 15th, 2020. Measurements of hemoglobin (Hb) and hematocrit (Hct) levels during birth supported the diagnosis of anemia. Hb levels were compared in three categories in this study: (1) Hb

This study compared the marginal and internal fit of implant-supported fixed dentures fabricated using CAD/CAM systems.A lower jaw model representing partial edentulism was produced. Two dental implants were inserted in the area of teeth 35 and 37, onto which cemented abutments were screwed. The model was scanned using a laboratory scanner and transferred to a design software program for substructure fabrication. Sixty substructures were fabricated out of each group for six substructure types (n = 10), cast Co-Cr (control), milling Co-Cr, laser sintering Co-Cr, titanium (Ti), zirconium, and polyetheretherketone (PEEK) substructures. The marginal and internal fit was evaluated using a silicone replica viewed under a stereomicroscope. The data were analyzed using the statistical package program for social sciences (SPSS, Chicago, IL, USA, v. 17) at a significance level of 0.05. Marginal and internal gaps were compared using the one-way ANOVA test and Tukey's post hoc test. The differences between abutment teeth were determined using the independent sample t-test.There was a significant difference in the marginal gap between PEEK and Ti groups (p 0.05) but no difference between other groups (p 0.05). There was a significant difference in the internal gap between PEEK, laser sintering Co-Cr, and milling Co-Cr groups (p 0.05) but no difference between other groups (p 0.05). The PEEK group had a higher marginal gap than the Ti group and a higher internal gap than the DMLS Co-Cr group (p 0.05).All substructures have a marginal and internal fit within acceptable clinical limits.This in vitro study suggests that materials and techniques used in CAD/CAM systems improve the fitting accuracy of implant-supported fixed restorations.

Background: The aim of the study was to evaluate the frequency of recurrence and the risk factors for recurrence in patients who were diagnosed with venous thromboembolism. Methods: Between January 2005 and January 2015, a total of 412 venous thromboembolism patients (164 males, 248 females; mean age: 53.5±16.6 years; range: 19 to 95 years) were retrospectively analyzed. The demographics, underlying risk factors, comorbidities, imaging findings, and treatment data of the patients were recorded. Results: At least one transient/permanent risk factor was found in 341 (82.7%) of the index events, and the other 71 (17.2%) were idiopathic. Recurrence developed in 76 (18.4%) of the patients. The duration of the treatment in the first event was significantly longer in recurrent cases (p=0.007). The recurrence rate in patients diagnosed with only deep vein thrombosis or patients diagnosed with pulmonary thromboembolism + deep vein thrombosis was significantly higher than the patients diagnosed with only pulmonary thromboembolism (24% vs. 14.2%, respectively; p=0.007). The rate of idiopathic venous thromboembolism was higher in recurrent cases than in non-recurrent cases (26.3% vs. 15.2%, respectively; p=0.028). At the end of the first year, the mean D-dimer levels were higher in recurrent cases (p=0.034). Hereditary risk factors were also higher in recurrent cases (39.5% vs. 19.3%, respectively; p=0.031). There was no significant correlation between recurrence and mortality. Conclusion: The presence of deep vein thrombosis, idiopathic events, high D-dimer levels at the end of the first year and hereditary risk factors seem to be associated with recurrence.

Severe acute respiratory syndrome coronavirus 2 infection can result in multisystem inflammatory syndrome in children (MIS-C). MIS-C can lead to myocardial dysfunction, heart failure, and multiorgan failure; the primary finding is hyperinflammation. Endothelial dysfunction has not been evaluated in patients with MIS-C. We investigated endothelial dysfunction and arterial stiffness parameters in patients with MIS-C. The study included 38 pediatric patients (20 males and 18 females aged 4–17 years, mean age 8.89 years) with MIS-C. Thirty-eight age- and sex-matched healthy individuals were enrolled as the control group. Systolic and diastolic ventricular measurements and systolic and diastolic measurements of ascending aorta diameter were performed by M-mode echocardiography. Endothelial dysfunction was evaluated using flow-mediated dilation by measuring the brachial artery diameter with a high-resolution probe. The MIS-C group had lower flow-mediated dilation than did the controls. The MIS-C group had decreased aortic strain and aortic distensibility values and correlations between decreased flow-mediated dilation and reduced aortic strain, aortic distensibility, and reduced ejection fraction. Conclusion: The results show that patients with MIS-C had endothelial dysfunction and arterial stiffness. Furthermore, the degree of endothelial dysfunction correlated with reduced ejection fractions. What is Known: •Endothelial dysfunction and arterial stiffness are unknown in patients with MIS-C. •The effect of endothelial dysfunction and arterial stiffness on decreased cardiac function is unknown. What is New: •MIS-C patients have endothelial dysfunction and arterial stiffness. •There is a link between left ventricular dysfunction and reduced endothelial dysfunction in patients with MIS-C.

Influenza is a disease of varying severity, characterized by respiratory tract involvement, involving the chest, bronchi and rarely the lung, caused by the RNA virus from the Orthomyxoviridae family. In influenza, whose symptoms are similar to seasonal flu, sudden onset of high fever, headache, sore throat, runny nose, widespread muscle aches in the body, fatigue, weakness, tremors and non-productive cough are predominant. Diarrhea and vomiting may also accompany the symptoms. The virus creates viruses in different genomes and causing new infections to occur, undergoing frequent changes thanks to the segments of its RNA encoding different proteins thus leading to various epidemics and pandemics. For influenza virus, which has two surface glycoproteins, Hemagglutinin (H) and Neuraminidase (NA), which determine the antigenicity and pathogenicity of the virus, these glycoproteins are important in determining the virus types. Influenza viruses have A, B and C main types according to nucleocapsid and matrix proteins. Thanks to its segmented genome structure, it has many subtypes with recombination and modification of sub-antigens. Although influenza causes disease in all age groups, certain groups are affected more. The elderly, those with chronic diseases, those with immunodeficiency, etc. is a group developing complications and mortality risk is high.Morbidity and mortality rates are high in this group. Complications develop with the addition of bacterial infections secondary to influenza.

Background/aim This study aimed to evaluate the effect of low- and high-pressure pneumoperitoneum pressures applied during robotic-assisted laparoscopic prostatectomy (RALP) using near-infrared spectroscopy (NIRS) on regional cerebral oxygenation saturation (rSO2). Materials and methods The prospective, comparative, and observational study included patients aged 18–80 years, with the American Society of Anesthesiologists (ASA) physical status I-II, who would undergo elective RALP. The patients were divided into two groups (12 mmHg of pneumoperitoneum pressure group, n=22 and 15 mmHg of pneumoperitoneum pressure group, n=23). Patients’ demographic data, durations of anesthesia, surgery, pneumoperitoneum, and Trendelenburg position, intraoperative estimated blood loss, fluid therapy, urine output, hemodynamic and respiratory data, and rSO2 values were recorded at regular intervals. Results The rSO2 values increased significantly during the pneumoperitoneum combined with steep Trendelenburg position (from t 3 to t 6 ) and at the end of the surgery ( t 7 ) in both groups, compared to the values 5 min after the onset of pneumoperitoneum in the supine position ( t 2 ) (P < 0.05), but no statistical significance was observed between the two groups. No cerebral desaturation was observed in any of our patients. Hemodynamic and respiratory parameters were preserved in both groups. The blood lactate levels were significantly higher in patients operated at high-pressure pneumoperitoneum, compared to those with low-pressure pneumoperitoneum (P < 0.05). Conclusion We believe that low-pressure pneumoperitoneum, especially in robotic surgeries, such as robotic-assisted laparoscopic prostatectomy (RALP), can be applied safely.

Objective: The aim of this study is to identify cancer earlier in life using machine learning methods. Methods: For this purpose, the Wisconsin Diagnostic Breast Cancer dataset was classified using Naive Bayes, decision trees, artificial neural networks algorithms and comparison of these machine learning methods was made. KNIME Analytics Platform was used for applications. Before the classification process, the dataset was preprocessed. After the pre-processing stage, three different classifier methods were applied to the dataset. Accuracy, sensitivity, specificity and confusion matrices were used to measure the success of the methods. Results: The results show that Naive Bayes and artificial neural network methods classify tumors with 96.5% accuracy. The success of the decision tree method in classification was 92.6%. Conclusion: The machine learning algorithms can be used successfully in breast cancer diagnosis to determine whether the tumors are malign or benign.

Purpose: The formation and pathophysiology of migraine attacks with aura are still ambiguous. Sterile inflammation is claimed to play a role in the pathogenesis of migraine. Neutrophil / lymphocyte ratio (NLR) is an inexpensive and practical indicator that can be well detectable from a complete blood count (CBC). This study, it was aimed to compare NLR in migraine patients, during attacks with aura, and without attack. Methods: A total of 98 patients diagnosed with migraine headache with aura and 34 healthy individuals without migraine were analyzed. All subjects were evaluated in terms of age, gender, CBC. NLR results were compared with migraine attacks with aura, periods without attacks, and 34 healthy controls. Results: The 98 patients, migraine with aura, had higher NLR values during attacks than migraine-free episodes and controls (p = 0.000, p = 0.000, respectively). Conclusions: NRL is a marker of inflammation, and we determined that NLR increases in migraine attacks especially as in other acute inflammatory situations. Pain can be prevented by taking, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans which inhibit neurogenic inflammation and neuroinflammation in the cascade, early at the onset of attacks.

ABTRACTWe aimed to assess the correlation between ISUP 2014 grades of needle biopsy (NB) and radical prostatectomy (RP) specimens and the parameters effecting this correlation. A total of 353 patients, who underwent a radical prostatectomy with diagnose of prostate cancer, were included in the study. Especially, the maximum percentage of core involved by cancer (MPCI) of upgraded group was significantly higher than those of correlated group and downgraded group. MPCI might be used as a preoperative value to determine risk classification and to help counsel patients with regard to treatment decision and prognosis of disease.

Background:. To evaluate the changes in penile sensation by electrophysiological tests in patients who underwent radical prostatectomy (RP) and to demonstrate the role of dorsal penile nerve injury in postoperative erectile dysfunction. Materials and methods:. Twenty-six volunteer patients who were eligible for RP were included in the study. Preoperative penile sensory electromyography and the International Index of Erectile Function-5 (IIEF-5) questionnaire were done for each patient. Erectile function assessment and electrophysiological evaluation of penile sensation were repeated at postoperative 3rd and 6th months. Results:. Postoperative IIEF-5 scores and electromyography values were significantly lower than preoperative findings (p 0.05). Conclusions:. Patients who underwent RP have decreased penile sensation due to cavernous nerve damage and a possible dorsal penile nerve injury. The decrease of penile sensation may be associated with postoperative erectile dysfunction.

Aim: The aim of this study was to evaluate the demographic characteristics, clinical presentation, antibody, and electrophysiological characteristics of patients with the diagnosis of Myasthenia Gravis (MG).Materials and Methods: The demographic characteristics, clinical presentation, antibody, electrophysiological and radiological (thoracic tomography) characteristics of the patients who were followed in the Neuromuscular and Muscular Diseases Polyclinic of the hospital between 2014-2019 were analyzed.Results: The mean age of the patients was 53.8±16.67 years. The mean disease duration was 4.8±5.05 years. Ptosis was the most common complaint in 79% (n=109) of our patients. The number of patients followed as pure ocular MG was 61.6% (n=85). There were 26 patients who presented with ptosis or diplopia at the first presentation and follow-up generalized MG with bulbar findings and weakness. Acetylcholine receptor antibody (AntiAChRAb) positivity was found in 78.3% (n=108) of the patients and thymus pathology was detected in thorax tomography in 37.7% (n=52).Conclusions: The initial complaint provides little insight into the course of the disease. The important factor is clinical follow-up. Although MG treatment is known, the pathophysiology of MG remains to be elucidated, and other autoimmune conditions cause changes in treatment choice. Clarifying the pathophysiology of MG will enable the development of more effective diagnostic and treatment methods., Amaç: Bu çalışmanın amacı, Myastenia Gravis (MG) tanısı ile izlenen hastaların demografik özellikleri, ilk başvuru şikayeti ile klinik seyir, antikor ve elektrofizyolojik özelliklerini değerlendirmektir.Gereç ve Yöntem: 2014-2019 yılları arasında, hastanemiz Nöromusküler ve Kas Hastalıkları Polikliniği’nde takip edilen yüz otuz sekiz MG hastasının demografik özellikleri, ilk başvuru şikayeti ile klinik seyri, antikor, elektrofizyolojik ve radyolojik (toraks tomografi) özellikleri incelendi.Bulgular: Hastaların yaş ortalaması 53.8±16.67 idi. Ortalama hastalık süresi 4.8±5.05 yıl idi. Hastalarımızın en sık, ilk başvuru şikayeti %79 (n=109)’unda ptozis idi. Saf oküler MG olarak takip edilen hasta sayısı %61.6 (n=85) kişiydi. İlk başvurusunda ptozis veya diplopi şikayetiyle gelip, daha sonrasında bulber bulgular ve güçsüzlük eklenerek jeneralize MG düşünülen 26 hasta bulunuyordu. Hastaların %78.3 (n=108)’ünde asetil kolin reseptör antikoru (AntiAChRAb) pozitifliği ve %37.7 (n=52)’sinde toraks tomografide timüs patolojisi bulundu.Sonuç: İlk başvuru şikayeti hastalığın seyri hakkında çok az fikir vermektedir. Asıl önemli olan, klinik yakın takiptir. Her ne kadar MG tedavisi bilinse de MG’in patofizyolojisi halen tam olarak aydınlatılamamıştır ve diğer otoimmun durumlar tedavi seçiminde değişikliğe neden olmaktadır. MG patofizyolojisinin aydınlatılması, daha etkin tanı ve tedavi yöntemlerinin geliştirilmesini sağlayacaktır.

Objective An important part of laparoscopic Nissen's fundoplication (LNF) is a proper wrap, which may only be possible with proper dissection of esophagus and hiatus. However, too much dissection of esophagus and hiatus to gain sufficient length of esophagus increases morbidity. The aim of this study is to analyze the effect of minimal esophagus dissection in LNF on recurrence and post-operative hiatal hernia. Methods The present study includes the children (0-18 years) who underwent LNF with minimal esophagus dissection and without hiatal closure between 2008 and 2016. The charts of the patients analyzed retrospectively and evaluated in terms of recurrence and post-operative hiatal hernia. Results There were 143 children. Mean age was 4.5±4.6 year (20 days-17 years). About 54% of the children (n=78) were neurologically impaired. There were two temporary intestinal obstructions which did not require surgery, one esophageal tightness which resolved with one dilatation session and one recurrence with hiatal hernia which required reoperation. Conclusion Minimal esophagus dissection without hiatal closure in LNF avoids dysphagia with no increase in the rate of recurrence and complications.

Objectives:The study aimed to reveal the clinical, laboratory and serological features of patients with antiphospholipid syndrome (APS) followed in a referral center and to demonstrate the possible differences of the patients with recurrent thrombosis.Materials and Methods:The data of 43 patients with APS, who applied to our center between January 2010 and January 2019, were scrutinized retrospectively. Clinical, laboratory and serological features of the patients were recorded. The patients with and without recurrent thrombosis were compared. P-value

Objective To investigate the value of presepsin and proadrenomedullin (proADM) as new markers for febrile neutropenia, by comparing them with conventional markers. Methods Plasma specimens for presepsin, proADM, C-reactive protein (CRP), and procalcitonin (PCT) were collected every 3 days during each episode of febrile neutropenia. Results A total of 39 patients experiencing a collective 47 episodes of febrile neutropenia with hematological malignant neoplasms, as well as 40 healthy control patients without infectious disease, were enrolled in this study. Levels of the studied analytes in the presepsin 1 group (with baseline values taken at admission), presepsin 2 group (values recorded on the 3rd day of febrile neutropenia), and presepsin 3 group (values recorded on the 6th day of hospitalization) were all higher in the subgroups with bacteremia. C-reactive protein 1 (baseline value taken at admission), procalcitonin 1 (as recorded at admission), and procalcitonin 2 (recorded on the 3rd day of febrile neutropenia) were higher in the subroups with bacteremia (P =.03, P = .04, and P = .04, respectively). In multivariate logistic regression analysis, presepsin 1 and/or PCT 1/CRP 1 combined analysis was superior in predicting bacteremia. Conclusion Presepsin could be used in combination with other biomarkers to detect bacteremia.

Purpose The aim of the study was to investigate the association between serum 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection and parameters of immune function and clinical outcomes. Methods Fifty-six patients, who were admitted to the emergency clinic and diagnosed with COVID-19 infection, were included in the study. Data on clinical characteristics, inflammatory parameters and vitamin D status were recorded for each patient. All the participants had data on 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection. Results The patients were stratified as those with vitamin D status less than 20 ng/mL and higher than 20 ng/mL. A group with vitamin D status less than 20 ng/mL had lower lymphocyte counts and lower haemoglobin levels that was statistically significant (respectively; p = 0.021, p = 0.035). Higher C-reactive protein (CRP) levels were seen in the vitamin D-deficient group (p = 0.013). It was observed that vitamin D status of the patients who required oxygen therapy were lower than those who did not require oxygen therapy, not statistically significant (p = 0.05). Patients who did not use vitamin D supplementation within 6 months prior to COVID-19 infection had more likely to be diagnosed with pneumonia (p = 0.004). Conclusion Cases with lower vitamin D status had increased inflammatory markers and worse clinical outcomes than patients with higher vitamin D status. This study suggests that vitamin D status can be used as a prognostic factor in COVID-19 patients, and vitamin D supplementation can be recommended to improve the clinical outcomes in COVID-19 infection.

Background/aim We aimed to identify clinical settings of renal transplant patients with COVID-19. Materials and methods In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented. Results Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/ day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients. Conclusion Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients.

BACKGROUND Powered transvenous lead extraction (TLE) tools are commonly required to remove the leads with long implant duration due to fibrotic adhesions. However, comparative data are lacking among different types of TLE tools. AIM To compare the efficacy and safety of two different rotational mechanical dilator sheaths in retrospectively analyzed patients who underwent TLE. METHODS AND RESULTS A total of 566 lead extractions from 302 patients using TightRail™ (333 lead extractions from 169 patients) and Evolution® (233 lead extractions from 133 patients) mechanical dilator sheaths were performed between July 2009 and June 2018. Acute and long-term outcomes of study groups were compared. There is no statistically significant difference between Evolution® and TightRail™ groups in procedural success (93.9% vs. 94%), clinical success (99.2% vs. 98%), and major complications (3.8% vs. 1.2%), respectively (p > .05). In multivariate regression analysis, lead dwell time, the number of extracted leads, and baseline leukocyte count were found as independent predictors of procedural success (p .05). Chronic renal disease, heart failure, and coagulopathy were shown as independent predictors of all-cause mortality in multivariate regression analysis (p

Aim of the study: To determine the parenchymal vascularity of the thyroid gland with color superb microvascular imaging in patients with Graves’ disease, and compare the vascularization index values with healthy subjects. Materials and methods: The thyroid glands of 37 patients whose laboratory and clinical findings were consistent with Graves’ disease, and 40 asymptomatic subjects with normal laboratory values, were examined using color superb microvascular imaging. Measurements of the vascularization index were performed with a free region of interest which was drawn along the outer margin of the gland on the color superb microvascular imaging mode. The vascularization index values obtained in the Graves’ disease and control groups were compared. A correlation analysis was performed between the vascularization index values and laboratory and grayscale US parameters. Results: The median vascularization index value of the thyroid parenchyma in patients with Graves’ disease was significantly higher than in the asymptomatic group [median (min–max); 12 (2.3–32.1) vs 5.04 (1.1–10.8), p

Introduction Placental insufficiency is one of the reasons for the reduction of hormone production. Thus, if one of the suspected causes of hypospadias is placental insufficiency, then the neurodevelopmental status of boys with hypospadias may be impaired. The aim of this study was to evaluate the neurodevelopmental status of boys with hypospadias and guide the parents of those who need support to related departments for early intervention. Materials and Methods Boys were divided into two groups, those with hypospadias (group H) and healthy children undergoing traditional circumcision (group C). The parents of the boys completed the Ages and Stages Questionnaire (ASQ) and ASQ–Social Emotional (SE), both of which are screening instruments for the early identification of developmental and social–emotional problems, respectively. Results Seventy-eight boys had hypospadias and 59 were admitted for traditional circumcision. The group H had statistically significant more impaired scores than group C in communication, gross motor, and personal–social skill sections. The multivariate logistic regression analysis revealed that hypospadias was the independent predictive factor for communication and personal–social skills. Conclusion Hypospadias and neurologic impairment may share common etiologic factors. Accordingly, physicians should keep in mind that if a boy presents with hypospadias, the possibility of having neurologic impairment is higher than normal population and early intervention has crucial importance. Every boy with hypospadias should be evaluated for neurodevelopmental status.

Purpose Biliary atresia (BA) is a disease that manifests as jaundice after birth and leads to progressive destruction of the ductal system in the liver. The aim of this study was to investigate histopathological changes and immunohistochemically examine the expression of glial cell line-derived neurotrophic factor (GDNF), synaptophysin, and S-100 protein in the gallbladder of BA patients. Methods The study included a BA group of 29 patients and a control group of 41 children with cholecystectomy. Gallbladder tissue removed during surgery was obtained and examined immunohistochemically and histopathologically. Tissue samples of both groups were immunohistochemically assessed in terms of GDNF, S-100 protein, and synaptophysin expression. Expression was classified as present or absent. Inflammatory activity assessment with hematoxylin and eosin staining and fibrosis assessment with Masson's trichrome staining were performed for tissue sample sections of both groups. Results Ganglion cells were not present in gallbladder tissue samples of the BA group. Immunohistochemically, GDNF, synaptophysin, and S-100 expression was not detected in the BA group. Histopathological examination revealed more frequent fibrosis and slightly higher inflammatory activity in the BA than in the control group. Conclusion We speculate that GDNF expression will no longer continue in this region, when the damage caused by inflammation of the extrahepatic bile ducts reaches a critical threshold. The study's findings may represent a missing link in the chain of events forming the etiology of BA and may be helpful in its diagnosis.

Objective The objective of this study was to report the first case of prenatal diagnosis of the fetal 20p13 microdeletion syndrome in the literature. Case report The mother was 31 years old and had a first trimester serum screening that indicated the fetus was at low risk. The prenatal ultrasound at 23 weeks of gestation showed mild ventriculomegaly (10.2 mm) and absent septum pellucidum. She underwent amniocentesis because of the abnormal imaging results. Karyotype analysis revealed normal results. Chromosome microarray analysis (CMA) was then performed to provide genetic analysis of the fetus and parents. CMA detected 317.902 kb deletion of 20p13 in fetus. Finally, pregnancy was terminated at 32 weeks of gestation. Conclusion This study is the first to report the prenatal diagnosis of a 20p13 microdeletion syndrome. Our results further confirmed that genes in this region, including SOX12, NRSN2 are essential for normal fetal growth and TBC1D20 for normal brain development.

Background Invasive fungal infections (IFIs) are a leading cause of morbidity and death in immunocompromised patients. Data on efficacy and pharmacokinetics of posaconazole in pediatric patients are rare (1 to 5). Herein, we retrospectively analyzed adolescent patients who had received posaconazole as antifungal prophylaxis. Methods We retrospectively analyzed patients who received posaconazole as primary or secondary antifungal prophylaxis. Results A total of 34 adolescent patients, 19 men (55.9%) and 15 women (44.1%) with a mean age of 15.8±2.1 years were included. Twenty-five of 34 (73.5%) patients were on primary and nine of 34 (26.5%) patients were on secondary antifungal prophylaxis. Diagnosis of the patients receiving posaconazole as primary antifungal prophylaxis were acute myeloid leukemia (n=12, 48%), hematopoietic stem cell transplantation (n=7, 28%), acute lymphoblastic leukemia (n=5, 20%), and Fanconi aplastic anemia (n=1, 4%). Five patients (55.6%) with hematopoietic stem cell transplantation, 1 patient with acute myeloid leukemia (11.1%), 1 patient with Fanconi aplastic anemia (11.1%), and 2 (22.2%) patients with chronic granulomatous disease received posaconazole as secondary antifungal prophylaxis. Twelve of 25 (48%) patients receiving posaconazole as primary antifungal prophylaxis were complicated by IFI; 4 of them were proven, 6 probable, and 2 with possible IFI. Three of 9 patients (33.3%) receiving posaconazole as secondary antifungal prophylaxis was complicated by IFI (P=0.29), 2 of them were probable and 1 was possible IFI. Five of 25 patients (20%) receiving posaconazole as primary prophylaxis died because of IFI. Conclusion Improvement of antifungal prophylaxis in patients with high risk of invasive infections seems clearly necessary, and analyzing serum posaconazole levels and individualizing dosing may be 1 approach to improve outcomes.

Percutaneous vertebroplasty is a well-known treatment modality for vertebral compression fractures caused by osteoporosis and malignant metastases. The procedure involves the injection of polymethyl methacrylate (PMMA, bone cement), into the desired vertebral body. Pulmonary cement embolism (PCE) refers to the embolization of PMMA into the pulmonary arteries. Patients are often asymptomatic and it may be detected incidentally for imaging done for another reason. The most common symptoms of pulmonary cement embolization are chest pain and breathlessness, and rarely it can present as acute respiratory distress syndrome. In this case, we aimed to present a 73-year-old male patient of PCE with computed tomography (CT) images. We want to raise the awareness that all patients undergoing vertebroplasty procedure should have routine chest X-ray after the procedure. However, CT is the best modality to determine PCE.

Objective: Calprotectin is an inflammatory biomarker which assesses disease activity in rheumatoid arthritis (RA). The objective of this study was to test whether serum calprotectin is associated with clinical and ultrasonographic disease activity in patients with RA, and to analyse its predicting value for disease activity evaluation despite normal C-Reactive protein (CRP) levels. Methods: We included 80 patients with RA and 30 healthy subjects. Patients were examined clinically and by ultrasound, (US7 score) along with laboratory parameters (calprotectin, CRP, erythrocyte sedimentation rate [ESR]). Disease activity scores (DAS28) were calculated to assess disease activity. Firstly, patients were divided into four subgroups according to the DAS28-ESR (high, moderate, low disease activity, and remission), then into two subgroups; group-1 (DAS-28≤3.2) and group-2 (DAS28>3.2). The predicting value of calprotectin for disease activity in patients with normal CRP was analysed with univariate and multivariate analysis and receiver operating characteristic curves. Results: Calprotectin levels were higher in RA patients than controls (96.3±45.9 ng/ml, 54.7±50.0 ng/ml, respectively; p

Ilkay Koca Kalkan,1 Gozde Koycu Buhari,1 Hale Ates,1 Buket Basa Akdogan,1 Ozlem Erdem Ozdedeoglu,1 Kurtulus Aksu,1 Ferda Oner Erkekol2 1Department of Immunology and Allergy, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey; 2Division of Immunology and Allergy, Department of Chest Diseases, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, TurkeyCorrespondence: Ilkay Koca KalkanDepartment of Immunology and Allergy, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Sanatoryum Cad, Keçiören, Ankara 06280, TurkeyTel +90 505 3117710Fax +90 312 3552110Email ilkay.koca@gmail.comPurpose: Local anesthetics (LA) are widely used and adverse drug reactions (ADR) occur in 2.5– 10%, but hypersensitivity reactions are rare (ranging between 0% and 4.3%). Risk is so overestimated causing too many allergy clinic referrals. There are limited and also conflicting results over the management of LA allergy. We aimed to find out who should be referred to an allergy clinic for a LA allergy testing, to define the subjects with an increased risk of LA allergy and to assess the need for testing for identifying alternative LA.Patients and Methods: We performed a retrospective study of patients referred to our clinic for diagnostic workup of LA hypersensitivity from 2006 to 2020.Results: In our cohort of 398 patients, tests were positive in 14 (3.52%) of them. Personal history of ADR with LA was the only independent risk factor for positive test (RR=4.007, p=0.033). Presence of generalized cutaneous symptoms and hypotension during past reaction were independent predictors of positive test (RR=9.043, p=0.021 and RR=10.445, p=0.038, respectively). The negative predictive value of intradermal test at dilution of 1:100 for immediate-type reaction was high (97.56%). Also, we demonstrated cross-reactivity within the amide-group LAs and co-occurrence of immediate- and delayed-type reactions.Conclusion: Only patients with an LA-induced ADR should be referred to an allergy clinic. History of generalized cutaneous symptoms and/or hypotension during the reaction may define subjects with an increased risk of LA allergy. A stepwise test procedure may start with skin tests especially for these patients with increased risk factors. In presence of LA allergy, alternative LA should always be confirmed by performing a challenge test.Keywords: intradermal tests, local anesthetics, drug hypersensitivity, skin tests, risk factors, prick tests

OBJECTIVES: To evaluate clinical features, laboratory test results, maternal and neonatal outcomes of pregnant patients with the Coronavirus disease (COVID-19). BACKGROUND: COVID-19 is a highly contagious disease caused by a severe acute respiratory coronavirus 2 (SARS-CoV-2). Healthy pregnant women are more susceptible to developing COVID-19. METHODS: We reviewed clinical data from pregnant patients with a laboratory-confirmed SARS-CoV-2, who were admitted to two tertiary care hospitals in Turkey. Demographic, clinical characteristics, laboratory test results, imaging findings, treatment received, maternal and neonatal outcomes were collected. RESULTS: A total of 24 pregnant women were enrolled in this study. The mean maternal and gestational age was 26.9±5.37 years and 24.15±10.61 weeks, respectively. Cough was observed as the most common symptom (n=15; 62.5 %). The lowest lymphocyte percentage was 20.83±13.05 (%). Nine women have delivered by Caesarean section, while one had a vaginal birth. One woman with critical COVID-19 died 2 days later postpartum. The neonate had been transferred to neonatal intensive care unit and died within 24 hours of birth. CONCLUSION: Our findings showed that except for one patient, the clinical course of COVID-19 during pregnancy was mild. Early hospitalization of pregnant women with confirmed and suspected COVID-19, liberal testing for SARS-CoV-2, active management with a multidisciplinary team seemed to be critical to recovery (Tab. 3, Ref. 31).

Takayasu arteritis is a rare inflammatory disease of large arteries. We performed a genetic study in Takayasu arteritis comprising 6,670 individuals (1,226 affected individuals) from five different populations. We discovered HLA risk factors and four non-HLA susceptibility loci in VPS8, SVEP1, CFL2, and chr13q21 and reinforced IL12B, PTK2B, and chr21q22 as robust susceptibility loci shared across ancestries. Functional analysis proposed plausible underlying disease mechanisms and pinpointed ETS2 as a potential causal gene for chr21q22 association. We also identified >60 candidate loci with suggestive association (p < 5 x 10(-s)) and devised a genetic risk score for Takayasu arteritis. Takayasu arteritis was compared to hundreds of other traits, revealing the closest genetic relatedness to inflammatory bowel disease. Epigenetic patterns within risk loci suggest roles for monocytes and B cells in Takayasu arteritis. This work enhances understanding of the genetic basis and pathophysiology of Takayasu arteritis and provides clues for potential new therapeutic targets., National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) [R01 AR070148]; National Institute of Arthritis and Musculoskeletal and Skin DiseasesUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) [U54 AR057319, U01 AR51874 04]; National Center for Research ResourcesUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Research Resources (NCRR) [U54 RR019497]; Office of Rare Diseases Research of the National Center for Advancing Translational Sciences; Imperial College, National Institute for Health Research, Biomedical Research Centre; Wellcome TrustWellcome TrustEuropean Commission [WT107881]; Medical Research CouncilUK Research & Innovation (UKRI)Medical Research Council UK (MRC)European Commission [MC_UU_00002/4], This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health grant R01 AR070148 to A.H.S. The Vasculitis Clinical Research Consortium has received support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (U54 AR057319 and U01 AR51874 04), the National Center for Research Resources (U54 RR019497), and the Office of Rare Diseases Research of the National Center for Advancing Translational Sciences. J.C.M., A.P.K., and R.M.M. acknowledge support from the Imperial College, National Institute for Health Research, Biomedical Research Centre. C.W. and G.R. acknowledge support from The Wellcome Trust (WT107881) and the Medical Research Council (MC_UU_00002/4). This work was supported by the use of study data downloaded from the dbGaP website, under dbGaP: phs000272.v1.p1, phs000431.v2.p1, phs000583.v1.p1, and phs000444.v1.p1.

Alzhiemer disease, which accounts for 70% of dementia caused by damage to the central nervous system, is a disease formed by combining genetic and environmental factors. In the pathogenesis of Alzheimer's disease, amyloid beta accumulation, Tau proteins, neurofibrillary tangles are involved. Inflammation, oxidative damage, insulin resistance, cholesterol, trace elements, metal exposure, carrying the Apolipoprotein E4 (ApoE) gene are risk factors. It is known that Alzheimer's disease does not occur with aging alone, environmental factors are needed. Although there is no definitive nutritional treatment for Alzheimer's disease, the Mediterranean diet is known to be protective and preventive against risk factors of Alzheimer's disease. The Mediterranean diet, which attracts attention with its rich consumption of fruits and vegetables, moderate consumption of white meat, limited in saturated fatty acids and rich in unsaturated fatty acids, is still popular today. Some changes in gout microbiota can affect Alzheimer's disease. Following a nutritional program that reduces inflammation, protects from free radicals and eliminates factors that increase nutritional amyloid beta accumulation can be protective. In addition to this nutrition program, vitamin and mineral supplements and probiotic supplements are recommended as a preventive for Alzheimer's.

Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.

Objectives The study was done experimentally to test the effect of diabetes on body mass index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose. Methods In the randomization performed, with 80 percent power, 80 people with Type 2 diabetes were found to be suitable for sampling. Personal data forms were filled in by conducting a face-to-face interview with both the experimental and control groups for randomization purposes. In the study, monitoring of BMI, LDL, HDL, systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose were used as outcome measures. Parameters were monitored pre-trial and at the 3rd, 6th, 9th, and 12th months. Data from the experimental group were collected online while data belonging to the control group were collected by the researcher from patients’ medical records in the Endocrinology Outpatient Clinic. Repeated measures analysis of variance (rANOVA) was performed to analyze pre-trial, 3rd, 6th, 9th, and 12th-month data. Results BMI, LDL, HDL, systolic and diastolic blood pressure, fasting and postprandial blood glucose average of the experimental group at 12 months were proven to be ameliorated compared to the average values at the start of the study (month 0). Conclusions The metabolic data of the experimental group, who had web-based diabetes education, significantly improved between the start of the study (month 0) and the 12th month. In this era of technology, the importance of web-based monitoring of diabetes patients was once again proven.