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Introduction: Extranodal marginal zone lymphoma (EMZL) is the most common subtype of conjunctival lymphoma. Management of conjunctival lymphoma consists of radiotherapy, surgery, chemotherapy, antibiotics and targeted therapies (Anti-CD 20) based on case series and retrospective studies. Appropriate treatment should be chosen based on the type of lymphoma, extent of spread, and patient-specific factors. We present two patients with localized disease diagnosed with primary conjunctival EZML by biopsy, for whom we planned different treatment plans. Case Reports: Case 1: A 64-year-old female patient presented with a pink-red mass on the lateral conjunctiva of her right eye. (Fig. 1A) Conjunctival biopsy was reported as Non-Hodgkin lymphoma, EMZL.(CD 20(+) and Ki-67 3-4%) No extraocular involvement on PET/CT. Orbital MRI showed a 2.5 cm soft tissue lesion surrounding the right globe laterally and posteriorly. The patient started rituximab and bendamustine treatment, and the lesion in the right orbit was not observed in the current follow-up imaging after 3 cycles of treatment. (Fig. 1B) The patient continued with rituximab and bendamustine treatment.Case 2: When the 52-year-old female patient first appeared two years ago, a conjunctival biopsy revealed that she had EMZL. Radiotherapy was recommended for her localized disease, but she declined it. She received eight cycles of rituximab treatment and was monitored in remission. One year later, salmon-colored lesions were found in the inner corner of both eyes. EZML was also found in the new biopsy. There was no ocular involvement. The patient received 6 cycles of rituximab bendamustine and maintenance rituximab for recurrent and bilateral lesions. We are currently monitoring the patient and the disease is in complete remission. Discussion: Lymphoma is one of the most frequently occurring malignant tumors of the conjunctiva. In patients with lesions that like a ''salmon patch'' and unexplained chronic follicular conjunctivitis, lymphoma should be suspected.

Objective: Electrocautery in laparoscopic surgeries converts abdominal carbon dioxide gas into carbon monoxide, which binds to hemoglobin with a higher affinity than oxygen and can impair oxygen transport and lead to hypoxia. This study aimed to assess changes in carboxyhemoglobin (COHb) levels and investigate the factors affecting COHb levels in patients undergoing robotic surgery. Methods: Forty-two patients were included in this retrospective study. Patient demographics, anesthetic used, airway pressures, and COHb levels at different time points (baseline COHb-1st hour COHb-post-pneumoperitoneum COHb-postoperative care unit COHb-deltaCOHb) were considered. Age, gender, American Society of Anesthesiology (ASA) physical score, body mass index, smoking status, surgery type, anesthesia type, patient position, fresh gas flow (FGF), insufflation, and airway pressures, which may have an effect on COHb levels, were compared. Results: No significant relationship was found between COHb levels at all measured time points and factors such as gender, ASA scores, surgery type, anesthesia type, position, FGF, insufflation pressure, and airway pressure. Smokers had significantly higher COHb levels than passive smokers, non-smokers, and ex-smokers at baseline (p=0.003), 1st hour (p=0.006), and post-pneumoperitoneum COHb (p=0.009) levels. Conclusion: Long surgery time, use of different types of anesthetics, and low FGF does not increase the risk of elevated COHb levels. Hence, different anesthetic drugs and low FGF, regardless of the position of the patient or the length of the procedure, can be used in robotic surgery without increasing the risk.

Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPA) is an extremely rare neoplasm that generally originates from the nasopharynx surface epithelium. The case presented herein is of a 70-year-old male patient referred from another centre, who was observed to have this tumour together with squamous cell carcinoma. The clinicopathological findings of this combination are presented, which has very rarely been mentioned in the literature. Although the prognosis of TL-LGNPA is generally excellent, it may sometimes be combined with other tumours, and therefore it must be kept in mind that it could have a clinically more aggressive course.

Our study aimed to determine the expressions of programmed death protein 1 (PD-1), programmed death ligand protein 1 (PD-L1), and cytotoxic T-lymphocyte- associated protein 4 (CTLA-4) to investigate and compare the differences between early and advanced cases in the 3 most common types of renal cell carcinoma (RCC) and reveal their correlations with prognosis and survival. A total of 166 RCC cases diagnosed between 2010 and 2019 in our hospital were included. PD-1, PD-L1, and CTLA-4 markers were applied to the paraffin blocks of the cases using an immunohistochemical method, and their expression status was evaluated by distinguishing subtypes in advanced- and early-stage RCCs. It was observed that PD-L1 positivity in the tumour cells, in clear cell RCC, was statistically significantly more frequent in advanced-stage cases compared to early-stage cases. It was concluded that cases with PD-L1 positivity in tumour- infiltrating mononuclear cells (TIMC) in clear cell and chromophobe RCC had a shorter survival. The frequency of perinephritic fat invasion and necrosis was higher in cases with PD-L1 expression in TIMC. We think that PD-1, PD-L1, and CTLA-4 must be considered together in advanced stage RCC for the treatment of both pathway inhibitors. Further large studies will shed light on the immunotherapy options at the advanced stage of all RCC types even in the absence of metastasis.

(1) Background: The introduction of novel therapies has led to a considerable evolution in the management of Multiple Myeloma, and chromosomal abnormalities predict the success of treatment. We aimed to characterize cytogenetic abnormalities for risk stratification in the patient population and to evaluate the predictive and prognostic value of the specified abnormalities in distinct treatment modalities. (2) Methods: This study included patients with Multiple Myeloma who applied to the Internal Medicine Clinic of the Cukurova University Faculty of Medicine. Between 2010 and 2023, 98 cases with cytogenetic abnormality data were identified. We analysed the effects of cytogenetic abnormalities on survival and response rates to first chemotherapies. (3) Results: P53 del was the most prevalent abnormality, and t(11;14) was the most common translocation. There was no significant difference in the mean survival and treatment response rates for specific cytogenetic abnormalities. When chemotherapies based on lenalidomide were initiated, patients’ life-death statuses differed significantly from those of treatments without lenalidomide. Regardless of the type of chromosomal aberration, lenalidomide-based treatments independently enhanced average survival 14-fold, while there was no significant difference in overall survival among treatments. (4) Conclusions: In individuals with cytogenetic abnormalities, lenalidomide-based treatments should be started regardless of the chemotherapy to be used for the condition.

Objective: The Oral Food Challenge Test (OFC) is the gold standard for diagnosing or excluding food allergies. OFC in children may cause anxiety in the parents. The study aims to evaluate parental anxiety during children's OFC, examining the impact of informational videos with instructions, comparing anxiety levels between tested children's parents and healthy controls, and correlating parental anxiety with psychological symptoms. Materials and Methods: The study included parents of children over 18 months of age undergoing OFC. All parents received verbal/ written test information and some got informational videos. State-Trait Anxiety Inventory (STAI) and Symptom Checklist-90-Revised (SCL-90-R) were used as questionnaires. Results: The median age of the 44 patients included in the study was 25.3 (IQR:20.2-41.6) months, and the median age of the 23 healthy children in the control group was 30 (IQR:23.85-43.96) months (p=0.125). Among the parents of the patients undergoing OFC, 29 (65.9%) were informed verbally/with text, and 15 (34.1%) were additionally provided information through video. Fourteen (31.82%) of the patients had an anaphylactic reaction in their history, and 36 (81.82%) patients were tested to evaluate the development of tolerance. No significant differences were detected in the STAI-T and STAI-S scores between parents of the control group and those of the group undergoing OFC. No statistically significant difference was observed in the assessment of the pre-OFC STAI-S scores of the patients' parents between those who received verbal/written information and those additionally informed via video. Among the parents' of patients without reactions during OFC, a decrease was noted in the post-test STAI-S scores compared to pre-test scores. STAI-T scores of the parents of patients undergoing OFC exhibited positive correlations with the general symptom index, anxiety, obsession, depression, interpersonal sensitivity, psychosis, paranoid, anger, and phobia parameters, as determined by the psychological symptom screening scale. Conclusion: As evidenced by our study, the absence of reactions during OFC resulted in a reduction of parental anxiety. The effect of additional video information with verbal and written instructions on anxiety remains unclear in this study. Limited sample size may be a factor; further research with larger cohorts is needed before making generalized conclusions. [ABSTRACT FROM AUTHOR]

İngiltere’ye çeşitli zamanlarda yerleşmiş yarım milyondan fazla Türk bulunmaktadır. Bu Türkler, dil ve kültürlerini korumak için faaliyetler yürütmektedir. Bunlardan birisi de çocuklarına Türkçe ve Türk Kültürü dersini aldırmaktır. İngiltere’de Türkçe ve Türk Kültürü dersi, Türkiye’den ve Kuzey Kıbrıs Türk Cumhuriyeti’nden (KKTC) gelen öğretmenler tarafından verilmektedir. 2020-2021 eğitim-öğretim yılı itibarıyla 38’i Türkiye’den, 11’i KKTC’den olmak üzere toplam 49 öğretmen tarafından bu ders verilmektedir. Bu çalışmada Türkçe ve Türk Kültürü dersinin İngiltere’de nasıl, nerede, hangi şartlarda verildiğini ortaya koymak amaçlanmıştır. Bu çalışmada Türkçe ve Türk Kültürü dersi bir fenomen olarak düşünülmüş ve fenomenolojik bir araştırma tasarlanmıştır. Türkiye Cumhuriyeti Londra Eğitim Müşavirliğine bağlı olarak görev yapan 10 öğretmenle bir odak grup görüşmesi gerçekleştirilmiş ve beş farklı konuda (ders ortamları, öğretmenler, öğrenciler, veliler, ders araç-gereçleri) onların görüşleri alınmıştır. Yapılan görüşmenin kayıtları analiz edilmiş ve bir bütünlük arz edecek şekilde düzenlenmiştir. Araştırma sonuçlarına göre, İngiltere’de Türkçe ve Türk Kültürü dersi için tahsis edilmiş belirli bir yer olmadığı; cami, halk eğitim merkezi veya resmi okullarda tahsil edilen odalarda eğitimin yapıldığı; her branştan öğretmenlerin bu ders için görevlendirildiği; ders araç gereçlerinin genellikle öğretmenler tarafından hazırlandığı; ulusal sınavlara Türkçe dersinden girenlerin derse daha fazla ilgi gösterdiği; velilerin ders açılması için çaba gösterdiği ancak ders açıldıktan sonra öğrenme ortamıyla çok fazla ilgilenmedikleri tespit edilmiştir.

Introduction: Dogs are among the most commonly allergenic pets for children. Data on risk factors for the development of dog allergy are scarce. This study aimed to evaluate the characteristics of children with dog allergy and identify predictors of symptom development with dog exposure. Methods: The study included children with dog allergen sensitization demonstrated by skin prick test (SPT) between September 1, 2019, and December 1, 2022. Demographic, clinical, and laboratory data were collected from the patients' records and interviews with parents. Results: Dog allergen sensitization was detected by SPT in 548 (5.5%) of 9,907 patients. Of these, 507 patients had complete data and were included in the analysis. The patients' median age was 11 (IQR: 8–15) years, 55.8% were male, 97.6% exhibited polysensitization (pollen 75.1%, cat 69.6%), 83.6% had allergic rhinitis, and 46.2% had asthma. Acute dog exposure caused symptoms in 164 patients (32.3%), most commonly sneezing (n = 97) and nasal symptoms (n = 80). Predictors of acute symptoms in dog-sensitized children were male sex (OR: 0.584 [CI: 0.38–0.87]), dog exposure before 1 year of age (OR: 2.35 [CI: 1.18–4.66]), close contact with a dog owner (OR: 2.93 [CI: 1.78–4.8]), and cat allergy (OR: 2.75 [CI: 1.82–4.1]). Conclusion: Approximately one-third of children with dog sensitization developed symptoms after exposure to the dog. Male sex, direct dog exposure before the age of one, close contact with a dog owner, and cat allergy were identified as predictors of dog allergy. [ABSTRACT FROM AUTHOR]

Copyright of Drama Therapy Review is the property of Intellect Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study introduces the first experimental analysis of shear cavitation in a microscale backward-facing step (BFS) configuration. It explores shear layer cavitation under various flow conditions in a microfluidic device with a depth of 60 μm and a step height of 400 μm. The BFS configuration, with its unique characteristics of upstream turbulence and post-reattachment pressure recovery, provides a controlled environment for studying shear-induced cavitation without the complexities of other microfluidic geometries. Experiments were conducted across four flow patterns: inception, developing, shedding, and intense shedding, by varying upstream pressure and the Reynolds number. The study highlights key differences between microscale and macroscale shear cavitation, such as the dominant role of surface forces on nuclei distribution, vapor formation, and distinct timescales for phenomena like shedding and shockwave propagation. It is hypothesized that vortex strength in the shear layer plays a significant role in cavity shedding during upstream shockwave propagation. Results indicate that increased pressure notably elevates the mean thickness, length, and intensity within the shear layer. Instantaneous data analysis identified two vortex modes (shedding and wake modes) at the reattachment zone, which significantly affect cavitation shedding frequency and downstream penetration. The wake mode, characterized by stronger and lower-frequency vortices, transports cavities deeper into the channel compared to the shedding mode. Additionally, vortex strength, proportional to the Reynolds number, affects condensation caused by shockwaves. The study confirms that nuclei concentration peaks in the latter half of the shear layer during cavitation inception, aligning with the peak void fraction region. [ABSTRACT FROM AUTHOR]

Amaç: Tiroid ince iğne aspirasyon sitolojisi (İİAS), tiroid nodüllerinin değerlendirilmesi için; hızlı, güvenilir, ekonomik bir yöntemdir. Bu yöntem hastaların ileri dönemde yönetimine katkı sağlamakta ve gereksiz cerrahi uygulamaları azaltmaktadır. Bu çalışmada İİAS sırasında, hasta başında yeterlilik değerlendirilmesinin, sitolojik yeterlilik ve histolojik kesin tanıda doğruluk oranlarına ne kadar katkısı olduğunu göstermek amaçlandı.Gereç ve Yöntem: Çalışmaya, 2012-2015 yılları arasında, bir üniversite hastanesinde İİAS uygulanmış 443 hasta dâhil edilmiştir. Hasta başında yeterlilik değerlendirilen ve değerlendirilmeyen olguların histolojik tanı kategorileriyle korelasyonu; duyarlılık, özgüllük, pozitif öngörü değeri, negatif öngörü değeri, tanısal doğruluk oranlarına göre karşılaştırılmıştır.Bulgular: Sitolojik ve histopatolojik tanıların karşılaştırılması sonucunda, hasta başı yeterlilik değerlendirilen grupta, duyarlılık %30,7, özgüllük %75, pozitif öngörü değeri %50, negatif öngörü değeri %57,1, tanısal doğruluk %55,1 olarak bulunmuştur. Hasta başı yeterlilik değerlendirilmeyen grupta ise duyarlılık %50, özgüllük %69,2, pozitif öngörü değeri %42,8 negatif öngörü değeri %75, tanısal doğruluk %63,1 olarak bulunmuştur.Sonuç: Hasta başı yeterlilik değerlendirilmesi, sitolojik yeterlilik oranını arttırır, ancak tanısal doğruluk oranına katkıda bulunmaz.

Multiple myeloma is a hematological cancer type. For its treatment, Bortezomib has been widely used. However, drug resistance to this effective chemotherapeutic has been developed for various reasons. 2D cell cultures and animal models have failed to understand the MM disease and Bortezomib resistance. It is therefore essential to utilize new technologies to reveal a complete molecular profile of the disease. In this review, we in-depth examined the possible molecular mechanisms that cause Bortezomib resistance and specifically addressed MM and Bortezomib resistance. Moreover, we also included the use of nanoparticles, 3D culture methods, microfluidics, and organ-on-chip devices in multiple myeloma. We also discussed whether the emerging technology offers the necessary tools to understand and prevent Bortezomib resistance in multiple myeloma. Despite the ongoing research activities on MM, the related studies cannot provide a complete summary of MM. Nanoparticle and 3D culturing have been frequently used to understand MM disease and Bortezomib resistance. However, the number of microfluidic devices for this application is insufficient. By combining siRNA/miRNA technologies with microfluidic devices, a complete molecular genetic profile of MM disease could be revealed. Microfluidic chips should be used clinically in personal therapy and point-of-care applications. At least with Bortezomib microneedles, it could be ensured that MM patients can go through the treatment process more painlessly. This way, MM can be switched to the curable cancer type list, and Bortezomib can be targeted for its treatment with fewer side effects.

We have investigated whether the lack of X-ray pulsations from most neutron star (NS) low-mass X-ray binaries (LMXBs) could be due to the extension of their inner disc to the NS surface. To estimate the inner disc radii, we have employed the model, recently proposed to account for the torque reversals of LMXBs. In this model, the inner disc radius depends on the spin period as well as the dipole moment and the mass inflow rate of the disc. Our model results indicate that most LMXBs have mass accretion rates above the minimum critical rates required for the inner disc to reach down to the NS surface and thereby quench the pulsed X-ray emission. For most sources X-ray pulsations are allowed when the period decreases below a certain critical value. For the same parameters, the model is also consistent with the observed X-ray luminosity ranges of the individual accreting millisecond X-ray pulsars (AMXPs). The paucity of AMXPs compared to the majority population of non-pulsing LMXBs is explained, as well as the fact that AMXPs are transient sources. [ABSTRACT FROM AUTHOR]

Objective: Studies examining COVID-19 vaccine reactions and reasons for parental hesitancy to COVID-19 vaccines in allergic adolescents are few. This study aimed to identify post-vaccine reactions and parental vaccine refusal/hesitancy among adolescents with allergic diseases. Materials and Methods: Between January 2022 and April 2022, a questionnaire was completed by the parents of adolescents who were followed at the Pediatric Allergy outpatient clinic. Vaccination status, characteristics of reactions after vaccination, and the frequency of parental vaccine hesitancy were recorded. Results: Among 104 patients, 70 were followed for asthma, 64 for allergic rhinitis, 12 for drug allergy, 3 for food allergy, and 1 for chronic urticaria. 63.5% (n=66) of the patients were vaccinated. The rate of vaccination was 52.5% in those with a history of COVID-19 and 70% in those without a history of COVID-19 infection (p=0.07). Eight patients were not vaccinated due to recent COVID-19 infection. Reasons for parental vaccine hesitancy/rejection (n=30) included thinking that the vaccine is harmful (63.3%), not effective (53.4%), or not suitable for children (46.7%). 14 (21.2%) children experienced symptoms within the first 2 hours after vaccination. The most common symptom (n=10) was arm pain. Urticaria and itching were reported in one patient and respiratory symptoms were reported in another patient. Both patients could receive the second dose without any reaction. Conclusion: Vaccination was more frequent among children without a history of COVID-19 infection. One third of the patients were not vaccinated, and the most common reason for vaccine hesitancy was concern about the adverse effects of the vaccine on human health in the long term and distrust of the vaccine. However, vaccinated allergic children did not experience any serious events. [ABSTRACT FROM AUTHOR]

Background: Fruit allergy usually presents with mild-to-moderate symptoms but serious systemic reactions, e.g., anaphylaxis, may also occur. Objective: This study aimed to examine the clinical and laboratory characteristics of patients with fruit allergy and fruitinduced anaphylaxis. Methods: Patients diagnosed with fruit allergy at Dı(skapı Hematology and Oncology Hospital and Bilkent City Hospital between January 2017 and January 2023 were included in the study. The diagnosis of anaphylaxis was made according to the European Allergy and Clinical Immunology Anaphylaxis Guideline. Results: During the study period, skin-prick tests with food allergens were performed on 9432 patients in our clinic, and fruit allergy was detected in 78 patients (0.82%). Five patients with inaccessible medical records were excluded from the study. 40 (54.8%) were boys. The median (interquartile range) age at the onset of symptoms was 72 months (12.5–144 months). Sixty-eight of the patients (93.2%) had a concomitant allergic disease, the most common of which was allergic rhinitis (n = 48 [65.8%]). The 73 patients had a history of reaction to 126 fruits. Twenty-five patients (19.8%) were allergic to multiple fruits. The most common fruit allergen was banana (22/126 [17.4%]), followed by peach (18/126 [14.2%]) and kiwi (17/126 [13.5%]). Mucocutaneous findings were observed most frequently after fruit consumption (120/126 [95.2%]). Anaphylaxis occurred in 17 patients (23.2%) with 21 fruits.The fruits most commonly associated with anaphylaxis were banana (6/21 [28.6%]) and kiwi (6/21 [28.6%]). Conclusion: Fruit allergy generally presents with mild symptoms, e.g., oral allergy syndrome, but severe systemic symptoms, e.g., anaphylaxis, can also be observed. Kiwi and banana are the fruits that most commonly cause anaphylaxis. Although more comprehensive studies are needed to comment on the development of tolerance, especially in patients with anaphylaxis, responsible fruit avoidance is still the most important strategy. [ABSTRACT FROM AUTHOR]

Objective Hydroxychloroquine (HCQ) has immunomodulatory, antithrombotic, cardiovascular, antimicrobial, and antineoplastic effects. In this study, we aimed to investigate the antiapoptotic and immunomodulator effects of intraperitoneal HCQ on hypoxic–ischemic (HI) injury in newborn rats. Study Design Wistar albino rats, 7 to 10 days old, were randomly divided into three groups: hypoxic–ischemic encephalopathy (HIE) group, HIE treated with HCQ group, and Sham group. Left common carotid artery ligation and hypoxia model were performed in HIE and HCQ groups. The HCQ group was treated with 80 mg/kg intraperitoneal HCQ every 24 hours for 3 days, while Sham and HIE groups were given physiological saline. After 72 hours, rats were decapitated and brain tissues were stained with hematoxylin and eosin, TUNEL, and IL-1β for histopathological grading and neuronal cell injury. Results Neuronal apoptosis was statistically lower in all neuroanatomical areas in the HCQ group compared with the HIE group. IL-1β-stained areas were similar in both HCQ and HIE groups but significantly higher compared with the Sham group. Histopathological grading scores were found to be lower in the HCQ group on the left parietal cortex and hippocampus region. Conclusion In this study, we have shown for the first time that HCQ treatment decreased apoptosis in HI newborn rat model in both hemispheres. HCQ may be a promising adjuvant therapy in neonatal HIE. Key Points HCQ decreased neuronal apoptosis in the ischemic penumbra of the rat brain. HCQ attenuates hypoxia–ischemia-induced brain injury in neonatal rats. HCQ has no anti-inflammatory effect on HI injury. [ABSTRACT FROM AUTHOR]

Copyright of Gazi Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Both passive and active microfluidic chips are used in many biomedical and chemical applications to support fluid mixing, particle manipulations, and signal detection. Passive microfluidic devices are geometry-dependent, and their uses are rather limited. Active microfluidic devices include sensors or detectors that transduce chemical, biological, and physical changes into electrical or optical signals. Also, they are transduction devices that detect biological and chemical changes in biomedical applications, and they are highly versatile microfluidic tools for disease diagnosis and organ modeling. This review provides a comprehensive overview of the significant advances that have been made in the development of microfluidics devices. We will discuss the function of microfluidic devices as micromixers or as sorters of cells and substances (e.g., microfiltration, flow or displacement, and trapping). Microfluidic devices are fabricated using a range of techniques, including molding, etching, three-dimensional printing, and nanofabrication. Their broad utility lies in the detection of diagnostic biomarkers and organ-on-chip approaches that permit disease modeling in cancer, as well as uses in neurological, cardiovascular, hepatic, and pulmonary diseases. Biosensor applications allow for point-of-care testing, using assays based on enzymes, nanozymes, antibodies, or nucleic acids (DNA or RNA). An anticipated development in the field includes the optimization of techniques for the fabrication of microfluidic devices using biocompatible materials. These developments will increase biomedical versatility, reduce diagnostic costs, and accelerate diagnosis time of microfluidics technology.