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Objective: To evaluate the development of anti-drug antibodies (ADAb) against tumor necrosis factor inhibitors (TNFi) therapy during a 2-year period and search the factors linked to patients with axial spondyloarthritis (axSpA). Methods: Biologic-naive patients with axSpA were included in this observational study. Serum drug levels and ADAb were measured at weeks 12, 24, 52, and 104 of treatment by enzyme-linked immunosorbent assay (ELISA). The development of ADAb and factors related to ADAb over time were investigated using generalized estimating equations (GEE). Results: A total of 180 patients with axSpA (116 male, mean (±SD) 45.6 (±11.9) years) who started TNFi treatment (etanercept (32.2%), adalimumab (27.2%), golimumab (20.6%), infliximab (20%)) were included. In the etanercept treatment group, only 1 patient had ADAb at 12 weeks and 24 weeks. Anti-drug antibodies against TNFi drugs were present in the adalimumab group in 32.7% of patients and in the infliximab group in 21.2% of patients at 12 weeks, and the proportion of ADAb-positive patients were found to be stable throughout the follow-up for adalimumab- and infliximab-treated patients. In the golimumab group, one patient had ADAb against golimumab at 12 weeks and the proportion of ADAb-positive patients increased throughout follow-up. In longitudinal analysis, baseline age, TNFi type, longitudinal Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and ASDAS-CRP scores, serum C-eeactive protein (CRP) levels, presence of adverse events and treatment discontinuation were associated with the presence of ADAb. Conclusion: The development of ADAb against TNFi therapy is associated with younger age, high disease activity, the development of adverse events and more common treatment discontinuation in patients with axSpA during 2-year follow-up.

Seyhan Taskin,1 Seyma Ozsoy,2 Ziya Cakir3 1Department of Physiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 2Department of Physiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey; 3Vocational Higher School of Health Services, Tokat Gaziosmanpasa University, Tokat, TurkeyCorrespondence: Seyhan Taskin, Department of Physiology, Faculty of Medicine, Harran University, Osmanbey Campus, Haliliye, Sanliurfa, 63300, Turkey, Tel +90 4143183000, Fax +90 414318 31 92, Email seyhan_taskin@yahoo.comPurpose: A combination of antiepileptic drugs and antioxidants may be an effective treatment by restoring the disrupted redox balance and reducing oxidative stress exposure to neurons. This study aims to evaluate the effects of valproate and vitamin B12 on oxidative stress in an experimental epilepsy model induced by penicillin when administered alone or in combination.Patients and Methods: 35 male Wistar rats were used in this study. The rats were divided into five groups, which were saline group, 1 mg/kg, 2 mg/kg Vit B12 groups and Sodium valproate group Sodium valproate + Vit B12 group. The epileptic activity was induced by 500 IU of penicillin injection. Sodium valproate and Vitamin B12 were administered 30 min after penicillin administration. Electrocorticogram recordings were taken for 2 hours post-treatment and serum parameters were assessed for oxidative stress markers using spectrophotometric method.Results: There is statistically significant difference between the groups in total antioxidant status, total oxidant status, and oxidative stress index value (p=0.013; p˂0.001; p˂0.001, respectively). The valproate+vitamin B12 group showed elevated total thiol and native thiol levels, along with reduced disulphide levels, resulting in the lowest OSI value.Conclusion: These findings suggest the combined treatment effectively reduces oxidative stress. This study provides valuable insights into the antioxidant properties of valproate and vitamin B12, positioning them as potential agents for managing epilepsy. Understanding the efficacy and reliability of antioxidant strategies in epilepsy management could contribute significantly to advancements in epilepsy therapeutics.Keywords: epilepsy, animal model, antiepileptic drug, Vitamin B12, oxidative stress

Meltem Oktay,1 Mehmet Asoğlu,2 Seyhan Taskin,3 Adnan Kirmit4 1Department of Psychiatry, Istanbul Training and Research Hospital, Istanbul, Turkey; 2Department of Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 3Department of Physiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 4Department of Biochemistry, Iskenderun State Hospital, Hatay, TürkiyeCorrespondence: Seyhan Taskin, Department of Physiology Harran University Medical Faculty, Osmanbey Campus, Haliliye, Sanliurfa, 63300, Turkey, Tel +90 4143183000, Fax +90 414318 31 92, Email seyhan_taskin@yahoo.comPurpose: Generalized Anxiety Disorder (GAD) is a chronic disease persisting for at least 6 months, characterized by excessive and continuous anxiety, which leads to evident problems and functional disorders. S100B is a glial protein that plays a role in intercellular communication regulating cell growth and differentiation, and intracellular signal transmission. This study aimed to analyze the serum S100B, 8-OHdG, and oxidative stress levels of patients newly diagnosed with GAD who had not started treatment, to better understand the underlying neurobiological basis of the etiology of GAD.Patients and Methods: Forty-four patients diagnosed with GAD according to DSM-5 diagnostic criteria and 44 healthy controls were included in the study. The Beck Anxiety Inventory (BAI) was used to determine the anxiety levels of the GAD patients. The serum S100B, 8-OHdG, total oxidant status (TOS), and total antioxidant status (TAS) levels were measured in the patient and control groups.Results: The 8-OHdG values of the GAD group were determined to be statistically significantly higher than those of the control group (p=0.028). No significant difference was determined between the GAD patients and the control group in respect of the TAS, TOS, and oxidative stress index (OSI) values (p> 0.05). The S100B levels of the GAD group were found to be higher than those of the control group.Conclusion: The results of this study showed that there could be DNA damage because of oxidative stress in GAD patients. There is a need for further studies to confirm the role of S100B protein in GAD etiology and pathogenesis.Keywords: generalized anxiety disorder, oxidative stress, 8-OHdG, DNA damage, S100B

Abstract Background The study aimed to investigate novel biomarkers from the C1q TNF superfamily and evaluate their role in autoimmune inflammatory rheumatic diseases with the goal of identifying an effective biomarker to measure clinical disease activity and assess treatment efficacy. Methods Sixty-one Axial spondyloarthritis (AxSpa) patients and 30 healthy controls were enrolled in the study. The serum biomarkers subfatin, CTHRC1, CTRP3, CTRP6, IL-6, IL-17, and TNF-α and the disease indices BASDAI, BASFI, MASES, and ASDAS–ESR/CRP were evaluated and compared. The patients were then classified, and their serum biomarkers were assessed according to their ASDAS scores and their treatment regimens. Results Among the studied biomarkers, none showed a significant difference between the patients and the healthy controls. Although the difference was not statistically significant, the median values of serum subfatin, CTHRC1, CTRP3, CTRP6, IL-6, IL-17, and TNF-α were all found to be lower in the AxSpa patients than in the healthy controls. Furthermore, once the patients were classified regarding their disease activity, no correlation between the study biomarkers and levels of clinical disease indices was observed. Finally, biological treatments were found to affect the serum concentration of these biomarkers regardless of the level of disease activity. Conclusion Novel adipokines and known modulators of inflammation, circulating subfatin, CTHRC1, CTRP3, CTRP6, IL-6, IL-17, and TNF-α levels may play a role in assessing treatment efficacy, especially in those treated with TNF-inhibitors. However, we failed to demonstrate a correlation between clinical disease activity and serum biomarker levels.

Introduction Muscle enzymes are an indicator of ongoing muscle damage and disease activity in patients with idiopathic inflammatory myopathy. Although platelet-related parameters have been shown to be useful as markers of disease activity in autoimmune diseases, the relationship between platelet distribution width (PDW) and disease activity has not been previously studied in polymyositis. We aimed to determine the relationship between PDW and disease activity in patients with polymyositis. Material and methods Twenty-seven patients with polymyositis and thirty healthy controls were included in the study. Disease activity was evaluated using the myositis disease activity assessment Visual Analogue Scale (MYOACT) and the Myositis Intention to Treat Index (MITAX). The relationship between PDW and disease activity was evaluated using Pearson’s or Spearman’s correlation and reliability was assessed using correlation coefficients. Results The mean platelet volume (MPV) and plateletcrit (PCT) were significantly higher and PDW was significantly lower in patients with polymyositis compared to the control group. The mean PDW levels were lower in patients with constitutional symptoms and arthralgia/arthritis (p < 0.005). Although PDW levels were lower in patients with mechanical hand, lung involvement, or dysphagia compared to patients without, there was no statistically significant difference between them. Platelet distribution width was found to be negatively correlated with disease activity. Conclusions We found that PDW was negatively correlated with MYOACT and MITAX, widely used tools in assessing the disease activity of polymyositis. Based on this, PDW may be utilized as a non-invasive potential index to assess disease activity in patients with polymyositis.

Introduction:The endothelial damage, changes in vascular permeability and plaque formation are caused by the effects of cytokines and chemokines that plays role in chronic inflammation in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). It has been reported that arterial stiffness and the level of cell adhesion molecules are affected by inflammation. In this study, we aimed to determine the relationship between vascular endothelial growth factor (VEGF), E-selectin, arterial stiffness and disease activity in patients with rheumatic diseases.Methods:Thirteen patients diagnosed with AS, 28 patients diagnosed with RA and 30 healthy controls were included in the study. Arterial stiffness, VEGF, E-selectin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were evaluated in all patients and healthy controls. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Disease Activity Score-28 (DAS-28) were calculated in patients with rheumatic diseases. The level of serum VEGF and E-selectin were determined by ELISA, and arterial stiffness was measured by oscillometric method. The data were statistically evaluated by using Student t-test, Mann-Whitney U Test and Wilcoxon test.Results:DAS-28, BASDAI, ESR and CRP levels were significantly decreased on the 3rd month of treatment in all patients (p

ABSTRACT BACKGROUND: Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN AND SETTING: Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Aydın, Turkey. METHODS: Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as > 6 typical episodes/year or > 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses. RESULTS: Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra. CONCLUSIONS: Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.

Aim: Anti-tumor necrosis factor-alpha (Anti-TNF-α) therapy has achieved an important position, are widely used for ankylosing spondylitis (AS) patients. TNF-α inhibition improves clinical outcomes and has differential effects on haematopoiesis. Information about effects on eosinophils is limited. The aim of our study is to determine the relationship between blood eosinophil counts in AS patients treated with TNF-α inhibitors. Methods: Seventy-five patients diagnosed with AS according to modified New York criteria were enrolled in this study. Disease activity was assessed by BASDAI, and erythrocyte sedimentation rate, C-reactive protein of patients were evaluated. All data were analyzed with Spearman’s correlation and Friedman's Two-Way by using SPSS version 19.0 statistical software, and p 0.05). It counts lower before anti-TNF-α therapy compare with post-treatment (130/mm3, 140/mm3 and 190/mm3, respectively). There was no statistically significant difference between pre- and 3rd month (p > 0.05), while correlation was found between pre- and 6th month, and also 3rd month and 6th month (p

Objectives: Fibromyalgia syndrome (FMS) is characterized by fatigue, memory problems, and widespread pain. The syndrome is present in about %2-8 of the general population. However, knowledge about this topic in specific populations is limited. Our aim was to evaluate FMS in patients undergoing peritoneal dialysis, hemodialysis, and control group, and the association between clinical and laboratory parameters.Patients and Methods: Eighty-nine dialysis patients and healthy volunteers were included in the study. The control group compromised 30 healthy adults (9 females 21 males with mean age of 52,9±16,3 years), 26 patients (7 females 19 males, with mean age of 53±15,9 years) receiving peritoneal dialysis and 33 patients (11 females and 22 males, with mean age of 64,5±7,1 years) receiving hemodialysis were enrolled in this study. Fibromyalgia was diagnosed with the criteria of 1990 American College of Rheumatology (ACR) and 2011 modification of the ACR preliminary diagnostic criteria. Gender, age, renal function tests, electrolytes, parathyroid hormone, renal failure etiology, and how long has it been dialyzed were recorded. Results: The prevalence of fibromyalgia was higher in patients with peritoneal dialysis compared with hemodialysis group. There was no statistically significant between peritoneal dialysis group and healthy group. Also, there was no statistically significant between for depression and cognitive functions between peritoneal dialysis group and healthy group. But, the parameter was found to be high in patients receiving hemodialysis compared with peritoneal and healthy groups. Kidney function tests and electrolyte levels were significantly different between healthy adults and dialysis groups (p lt;0.001).Conclusion: The prevalence of fibromyalgia was similar between peritoneal dialysis and healthy group. It may be related to actively participate in treatment, fewer stress factors, and better preservation of renal functions.

Bu araştırmanın amacı “İlkokul Türkçe 1 Ders Kitabı’nın öğretim programındaki temel becerilere uygunluğu açısından incelenmesidir. Böylelikle Türkçe Öğretim Programı’nın kazandırmayı amaçladığı anahtar yetkinlikler ve temel becerilerin 2017-2018 Öğretim Yılı’nda birinci sınıflarda uygulamaya konulan Türkçe ders kitabına ne şekilde yansıdığı sınanmış olacaktır. Araştırmada 2017-2018 Öğretim Yılı’nda birinci sınıflarda okutulan Türkçe ders kitabında yer alan metin öncesi hazırlık soruları, metinler ve bu metinlere bağlı etkinlikler; 2017 Türkçe Dersi Öğretim Programı’ndaki her bir beceriye uygunluğu bakımından ayrı ayrı incelenmiştir. Nitel araştırma yöntemlerinden durum çalışması araştırmasının kullanıldığı çalışmada veriler doküman analizi yöntemiyle toplanmıştır. Çalışmanın bulguları tablolar halinde sunulup yorumlanmış ve elde edilen sonuçlar bağlamında öneriler geliştirilmiştir.

A 69-year-old female patient was admitted to our clinic with photosensitivity, symmetric erosive polyarthritis, and cutaneous vasculitis of lower extremities. Rhupus syndrome was diagnosed, and Chiari's network in the right atrium and interatrial septum patent foramen ovale was achieved on transthoracic and transesophageal echocardiography. If it is thought that increased prevalence of antiphospholipid antibodies in patients with rhupus, this congenital remnant is important for the thrombosis risk, cardiac event, and stroke. The association of both diseases may lead to more serious events and cause worse prognosis. Here, our aim is to present a 69-year-old female patient with rhupus syndrome presenting with cutaneous vasculitis and Chiari's network in the right atrium.

Eğitim, gerek ilkokul gerek ortaokul gerekse lise ve üzeri seviyelerde olsun mutlaka belirli bir program dâhilinde ilerlemek zorundadır. Programlar toplumun ihtiyaçlarını göz önünde bulunduran, toplumda yer alan bireylerin gelişimleri için geniş fırsatlar sunan bir yapıda düzenlenmelidir. Programlarda önemli bir adım da toplumsal iletişime katkı sağlamak olmalıdır. İletişime katkı sağlamak için bir programın bireylerin söz varlığını geliştirecek şekilde planlanması gereklidir. İlkokul eğitimi öğrencilerin eğitim-öğretim hayatının başlangıcı olması yönüyle ayrı bir öneme sahiptir. Bu konuya iletişim açısından bakıldığında ise ilkokul programlarının çocukların toplumsal iletişimini destekler nitelikte olması gerekir. Dolayısıyla söz varlığı bakımından ilkokul programları düzgün yapılandırılmış bir içeriğe sahip olmalıdır. Bu çalışmanın amacı Cumhuriyet dönemi ilkokul Türkçe dersi öğretim programlarının öğrencilerin söz varlığı unsurlarını geliştirmesi açısından incelenmesidir. Çalışmanın inceleme nesnesini ilkokul Türkçe dersi öğretim programları (1924, 1926, 1930, 1936, 1948, 1968, 1981, 2005, 2015) oluşturmaktadır. Nitel bir araştırma olan bu çalışmanın verileri doküman inceleme tekniği ile toplanmış ve içerik analizi ile çözümlenmiştir. Çalışmanın temel veri kaynağı olan “Cumhuriyet Dönemi İlkokul Türkçe Dersi Öğretim Programları” araştırmacılar tarafından ayrı ayrı çözümlenmiş ve aralarındaki uyuma bakılarak yorumlanmıştır. Her bir programın söz varlığı bakımından bir öncekine göre üstün nitelikler taşıdığı ancak bütün programların bu bakımdan olması gerektiği yerde olmadığı, bununla birlikte ilkokul öğrencilerine yönelik bir söz varlığı listesinin olmamasının da programların bir eksikliği olarak karşımıza çıktığı sonuçlarına ulaşılmıştır. Çalışmada ulaşılan sonuçlardan yola çıkılarak ilkokul programlarında ortak kelime hazinesi listelerinin yer alması gerektiği önerisinde bulunulmuştur.

We present a case of 45-year-old female patient with the diagnosis of seropositive rheumatoid arthritis, who was admitted to our rheumatology department with exacerbation of the disease. The patient’s disease activity score (DAS 28) was 6.9. Physical examination revealed changes in the lung auscultation as a rough breathing sound at the middle and lower lobe of the right lung. Chest X-ray revealed multiple nodular densities in both lungs. Lung biopsy was performed for the diagnosis and revealed necrotizing granulomas with central fibrinoid necrosis surrounded by epithelioid cells. Such a histopathological picture is typical for rheumatoid nodules. Finally the patient was treated with rituximab, with significant improvement.

Abstract The first International Chapel Hill Consensus Conference was held in 1994. There have been suggestions about the nomenclature of systemic vasculitis. Important categories were added to the classification of vasculitis, and many changes were made for disease names in the second Chapel Hill Consensus Conference 2012, which were not included in the Chapel Hill Consensus Conference 1994. The new nomenclature was introduced instead of being referred to by many names such as Churg-Strauss and Wegener"s. New categories such as Behçet"s and Cogan etc. were also added. These people are honored by the classification. They contribute to science through their case studies, scientific articles, and observations. This article reviews only eponyms present in the current classification of vasculitis. The aim of this paper is to give information about scientists mentioned in the classification of vasculitis.

Objectives: The aim of this study was to evaluate the prognostic value of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in the uterine cervix cancer patients., Methods: Thirty-two women (mean age: 52.7±12.6) who underwent 18 F-FDG PET/CT for staging of uterine cervix cancer were retrospectively recruited for the study. Maximum standardized uptake value (SUV max ), SUV mean , metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors, lymph nodes, and distant metastases were calculated from 18 F-FDG PET/CT images using the 40% threshold. Patients were divided into groups according to the presence of pelvic and para-aortic lymph node involvement on 18 F-FDG PET/CT images. Life tables and Kaplan-Meier analyses were performed to compare the mean survival times of the different groups., Results: Primary tumor of 27 (84%) patients were 18 F-FDG avid. The median SUV max , SUV mean , MTV, and TLG of the primary tumors were 12.4, 6.1, 13.2 cm 3 and 87.8 g/mL x cm 3 respectively. Pathological uptake was detected in pelvic 14 (44%) patients and in paraaortic lymph nodes in 3 (10%) para-aortic lymph nodes. The median whole-body MTV and TLG were 21.7 cm 3 and 91.1 g/mL x cm 3 . Disease progression was detected in 7 (22%) patients within a median follow-up period of 20.9 (minimum-maximum: 3-82) months. The only significant PET parameter to predict progression-free survival was SUV max in the primary tumor (p=0.038). During follow-up period 8 patients died. SUV max (p=0.007), MTV (p=0.036), TLG (p=0.001) of primary tumor, presence of pathological uptake on pelvic or paraaortic lymph nodes (p=0.015), whole-body MTV (p=0.047) and whole-body TLG (p=0.001) were found statistically significant PET parameters to predict overall survival., Conclusion: Metabolic parameters of primary tumors derived from 18 F-FDG PET/CT images have prognostic importance for patients with uterine cervical carcinoma. In patients with metastatic disease, higher whole-body MTV and TLG are also associated with poor prognosis., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of the Turkish Society of Nuclear Medicine.)

Objective: To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT)., Methods: A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study., Results: The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years. According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210 (65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1-276 months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%) patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914-19.878; p=0.002), 3.755-fold in stage II-IV (95% CI=1.275-11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017-6.233; p=0.046) increased., Conclusion: In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS., Competing Interests: No potential conflict of interest relevant to this article was reported., (© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)

The purpose of this study was to reveal the combined effects of propolis (P) and quercetin (Q) against diabetic peripheral neuropathy developing with streptozotocin-induced diabetes in rats. Sixty-four adult male rats were divided into eight equal groups: control, P (100 mg/kg/day), Q (100 mg/kg/day), P + Q (100 mg/day for both), diabetes mellitus (DM) (single-dose 60 mg/kg streptozotocin), DM + P, DM + Q, and DM + P + Q. The rats were sacrificed, and blood and sciatic nerve tissues were collected. Blood glucose and malondialdehyde (MDA) levels increased, while IL-6 and total antioxidant status decreased in the DM group ( p = 0.016 and p = 0.047, respectively). Ultrastructural findings showed degeneration of the axon and myelin sheath. The apoptotic index (AI %), TNF-α, and IL-1β immunopositivity increased significantly in the DM group ( p < 0.001). Morphological structures approaching those of the controls were observed in the DM + P, DM + Q, and DM + P + Q groups. Morphometric measurements increased markedly in all treatment groups ( p < 0.001), while blood glucose and MDA levels, AI (%), TNF-α, and IL-1β immunopositivity decreased. In conclusion, the combined effects of propolis and quercetin in diabetic neuropathy may provide optimal morphological protection with neuroprotective effects by reducing hyperglycemia, and these may represent a key alternative supplement in regenerative medicine.

Objective: Obesity, a prevalent chronic disease, results from an imbalance between energy intake and expenditure. The oxidative stress associated with obesity stems from an imbalance between reactive oxygen species and the cell's antioxidant defense system. Oxidative stress can cause many diseases. The assessment of thiol/disulfide balance, a biochemical test, can be used to detect oxidative stress. The aim of this study is to determine the changes in oxidative stress associated with obesity after obesity surgery by assessing the thiol/disulfide levels., Patients and Methods: The study was conducted with 40 volunteer patients with a body mass index (BMI) above 40 who underwent obesity surgery at Harran University Hospital General Surgery. Thiol and disulfide levels and other blood parameters were measured from the preoperative and postoperative 2nd and 6th-month blood samples of the patients. BMI was calculated by recording the weights and heights of the cases. Patients with diseases that could affect oxidative stress measurements and those using medication were excluded from the study, and the analyses were performed accordingly., Results: The results showed a statistically significant decrease in native thiol, disulfide, reduced thiol, oxidized thiol, glucose, ALT (alanine aminotransferase), ALP (alkaline phosphatase), total cholesterol, HDL (high-density lipoprotein), triglyceride, and BMI values between the preoperative, 2-month postoperative, and 6-month postoperative measurements (p<0.05)., Conclusions: Restrictive methods such as sleeve gastrectomy in individuals with morbid obesity led to weight control and a decrease in adipose tissue, reducing oxidative stress and increasing antioxidant response.

Objective: The purpose of this study was to assess prognostic factors correlated with recurrence and decreased oncologic outcomes, as well as the role of adjuvant treatment on survival in women with stage I and II endometrioid endometrial cancer without lymphovascular space invasion (LVSI)., Material and Methods: Patients with LVSI negative, early-stage endometrioid endometrial cancer patients were retrospectively reviewed. Multivariable logistic regression models were used for identifying predictors of recurrence. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method, and survival curves were compared by log-rank test. Univariable and multivariable analyses were performed to establish factors affecting OS and DFS. Hazard ratios with 95% confidence intervals were calculated., Results: A total of 289 patients were included, with a mean age of 58 years and the median surveillance time of 45 (6-147) months. The majority of the patients (54%) had grade 1 tumors. Adjuvant therapy was administered to 68 (23.5%). A total of 13 (4.5%) recurred with median time to recurrence of 52 months. Patients receiving adjuvant treatment were more likely to recur (p=0.015), and grade was the only independent predictor of recurrence (p=0.029). Five-year OS and DFS were 95.8% and 97.9%, respectively. While tumor size (p=0.018) and grade 3 histology (p=0.045) were related with shorter DFS, age (p<0.001) was the only related factor for decreased OS., Conclusion: Recurrence rate was low among LVSI negative, early-stage endometrioid endometrial cancer patients. Although recurrences were seen more frequently in patients who received adjuvant treatment, it wasn't an independent prognostic factor. Neither recurrence nor adverse uterine risk factors were associated with shorter OS. While age was the only prognostic factor for decreased OS, grade 3 histology and tumor size were associated with decreased DFS., Competing Interests: Conflict of Interest: No conflict of interest is declared by the authors., (©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation. Journal of the Turkish-German Gynecological Association is published by Galenos Publishing House.)

Objective: COVID-19 is a deadly disease. Investigations are being conducted on the underlying mechanisms to predict prognosis and reduce mortality rates. In this study, the extent of DNA damage and serum levels of oxidized biomolecules were investigated. We hypothesize that malondialdehyde (MDA) and protein carbonyl (PC) serum levels and DNA damage levels may be biomarkers that can be used in prognostic decision making and prediction of mortality in COVID-19 patients., Patients and Methods: Patients included in the study were divided into two groups according to their survival. These groups were compared in terms of serum MDA, PC levels, DNA damage degrees and mortality on the 1st, 3rd, and 5th days of ICU admission., Results: In patients who died, MDA levels increased over time (p=0.023), PC levels peaked on the third day of admission to the intensive care units (ICU), and then decreased, while DNA damage increased gradually (p=0.013). In surviving patients, MDA levels decreased over time (p=0.018); PC levels were at their peak on the first day of admission to the ICU and then decreased (p=0.018); DNA damage decreased initially, and then increased minimally compared to Day 1., Conclusions: For COVID-19 ICU patients, serum levels of MDA and PC and degrees of DNA damage can strengthen prognostic decision-making and contribute to reducing mortality.

Introduction: Evaluation of the prognosis in the early period of intensive care patients and arranging the treatment accordingly is of vital importance. In the present study, we investigated whether serum thiol/disulphide concentration can be used in the follow-up of prognosis in the early period in patients with COVID-19 under intensive care., Methods: The study included 25 patients [their ages were between 19 and 92; 10 (40%) were male and 15 (60%) were female] who were diagnosed with COVID-19 and treated in the intensive care unit (ICU). The patients were followed for four weeks. On the first, third, and fifth days of intensive care treatment, venous blood samples were taken from the patients to analyze the thiol/disulphide parameters, and coma scores were calculated. Statistical analyses were conducted to evaluate the relationship between thiol/disulphide levels and the prognosis of COVID-19 patients., Results: At the end of the four-week follow-up of the patients included in the study, 9 were discharged and 16 died. In patients who died, the relationship between thiol/disulphide homeostasis parameters and coma scores was not statistically significant. Meanwhile, in discharged patients, the relationship between disulphide concentration, total thiol, and coma scores was statistically significant., Conclusion: The relationship between thiol/disulphide homeostasis and coma scores in COVID-19 patients treated in the intensive care unit may help to evaluate the prognosis of the disease in the early period, thus the effectiveness of medical intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Duran et al.)

Background: In this single-center study, we aimed to analyze texture features of primary uterine lesions on 18F-FDG PET/CT to predict lymph node metastases., Methods: Totally, 157 (mean age: 62 ± 10.2 years) patients were included in the analysis. Histopathological examination results were considered as the standard reference for nodal involvement. On 18F-FDG PET/CT images, only the primary tumor was segmented. SUVmax, SUVmean, SUVpeak, MTV, and TLG of primary uterine lesions were calculated for analyses. For texture analysis first, second, and higher-order texture features were calculated., Results: Mean diameter of primary uterine lesions was calculated as 35± 18.1 mm. Lymph node metastases were detected in 19% of patients in histopathological examination of surgical materials. While 26 patients had pelvic lymph node metastases, 19 patients had additional paraaortic lymph node metastases. On radiomics analysis for 20 features, a significant difference was found between patients with and without lymph node metastasis. With using data mining methods GLZLM ZLNU, EntropyGLCM, Entropyhisto, GLRLM LRHGE, GLZLM HGZE, GLZLM SZHGE, GLRLM HGRE, GLRLM SRHGE were found significant radiomics features to predict lymph node metastasis with a diagnostic accuracy of 0.8., Discussion: The radiomics analysis of intratumoral heterogeneity is a promising method for improving triage of the patients for lymph node dissection in endometrial carcinoma.

Objective: To evaluate the clinico-pathological patient features, prognostic factors, treatment options and outcomes of peripheral nodal recurrence (PNR) of endometrial cancer (EC)., Material and Methods: The data of nine patients with PNR of EC from two institutions were reviewed. The electronic literature was reviewed from 1972 to May 2018 to identify articles about PNR in EC. Finally, 42 cases were evaluated., Results: Nineteen (45.2%) patients were initially diagnosed with either stage I or II disease, whereas 20 (47.7%) patients had stage III or IV disease while the stages were not reported in three (7.1%). PNR developed as the first recurrence in 40 (95.2%) patients and as the second recurrence in 2 (4.8%) patients. Isolated PNR appeared in 35 (83.3%). Seven (16.7%) had PNR coexisting with multiple other sites of tumoral involvement. In the entire cohort, the 5-year and 10-year post-recurrence survival (PRS) were both 78%. Only the presence of distant hematogenous metastasis concurrent with PNR was significantly related to poor PRS (p=0.005). Among patients with isolated PNR, those who had surgery had 30% greater 5-year PRS than those treated without surgery, but this difference was not significant (80% vs 50%; p>0.05)., Conclusion: A concurrent distant hematogenous metastasis was the only factor related to poor survival. A wide range of therapies exists for PNR but none of the therapies appear to be more advantageous than another. However, surgery as a component of treatment can render a survival advantage for patients who have isolated PNR.

Introduction: This study aimed to evaluate the diagnostic accuracy of the sentinel lymph node (SLN) mapping algorithm in high-risk endometrial cancer patients., Methods: Two hundred forty-four patients with non-endometrioid histology, grade 3 endometrioid tumors and/or tumors with deep myometrial invasion were enrolled in this retrospective, multicentric study. After removal of SLNs, all patients underwent pelvic ± paraaortic lymphadenectomy. Operations were performed via laparotomy, laparoscopy or robotic surgery. Indocyanine green (ICG) and methylene blue (MB) were used as tracers. SLN detection rate, sensitivity, negative predictive value (NPV) and false-negative rate (FNR) were calculated., Results: Surgeries were performed via laparotomy in 132 (54.1%) patients and 152 (62.3%) underwent both bilateral pelvic and paraaortic lymphadenectomy. At least 1 SLN was detected in 222 (91%) patients. Fifty-five (22.5%) patients had lymphatic metastasis and 45 patients had at least 1 metastatic SLN. Lymphatic metastases were detected by side-specific lymphadenectomy in 8 patients and 2 patients had isolated paraaortic metastasis. Overall sensitivity, NPV and FNR of SLN biopsy were 81.8%, 95% and 18.2%, respectively. By applying SLN algorithm steps, sensitivity and NPV improved to 96.4% and 98.9%, respectively. For grade 3 tumors, sensitivity, NPV and FNR of the SLN algorithm were 97.1%, 98.9% and 2.9%., Conclusion: SLN algorithm had high diagnostic accuracy in high-risk endometrial cancer. All pelvic metastases were detected by the SLN algorithm and the isolated paraaortic metastasis rate was ignorable. But long-term survival studies are necessary before this approach becomes standard of care., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aim: This multicenter investigation was performed to evaluate the adjuvant treatment options, prognostic factors, and patterns of recurrence in patients with grade 3 endometrioid endometrial cancer (G3-EEC)., Materials and Methods: The medical reports of patients undergoing at least total hysterectomy and salpingo-oophorectomy for G3-EEC between 1996 and 2018 at 11 gynecological oncology centers were analyzed. Optimal surgery was defined as removal of all disease except for residual nodules with a maximum diameter ≤ 1 cm, as determined at completion of the primary operation. Adequate systematic lymphadenectomy was defined as the removal of at least 15 pelvic and at least 5 paraaortic LNs., Results: The study population consists of 465 women with G3-EEC. The 5-year disease-free survival (DFS) and overall survival (OS) rates of the entire cohort are 50.3% and 57.6%, respectively. Adequate systematic lymphadenectomy was achieved in 429 (92.2%) patients. Optimal surgery was achieved in 135 (75.0%) patients in advanced stage. Inadequate lymphadenectomy (DFS; HR 3.4, 95% CI 3.0-5.6; P = 0.016-OS; HR 3.2, 95% CI 1.6-6.5; P = 0.019) was independent prognostic factors for 5-year DFS and OS., Conclusion: Inadequate lymphadenectomy and LVSI were independent prognostic factors for worse DFS and OS in women with stage I-II G3-EEC. Adequate lymphadenectomy and optimal surgery were independent prognostic factors for better DFS and OS in women with stage III-IV G3-EEC., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)