Prevalence, determinants, and fibrosis risk stratification of metabolic-associated fatty liver disease in a Turkish primary care setting: A retrospective study.

Background and Aim: Metabolic-associated fatty liver disease (MAFLD) is a condition that frequently goes unnoticed as it typically remains asymptomatic until progressing to an advanced stage. As a result, it is essential to implement opportunistic screening initiatives within family medicine practices to accurately identify and refer selected at-risk patients to specialized care. This study aims to investigate the prevalence of MAFLD and advanced hepatic fibrosis among primary care patients in Turkiye by utilizing non-invasive tests. Materials and Methods: We performed a retrospective analysis of prospectively collected data from February 1, 2022, to April 14, 2023, at a Family Medicine Outpatient Clinic. The Hepatic Steatosis Index (HSI) was used to identify fatty liver cases, followed by established MAFLD criteria for diagnosis. Patients were then categorized based on advanced fibrosis risk using the fibrosis-4 (FIB-4) index. Results: Among the 450 patients who sought primary care during the study period (286 women and 164 men; mean age: 48.2±13.7 years), 295 (65.6%) were diagnosed with MAFLD using HSI values and established criteria. Diabetes mellitus emerged as the sole independent predictor of MAFLD. FIB-4 values classified 242 (82%) and 53 (18%) patients with MAFLD at low and intermediate risk of advanced fibrosis, respectively, with none at high risk. Conclusion: MAFLD exhibits a notable prevalence among Turkish patients who presented at a Family Medicine Outpatient Clinic. Given the growing impact of metabolic diseases, primary care providers and non-liver specialists should actively participate in MAFLD screening programs.

Neurologic manifestations of Behçet disease: rheumatology experience.

OBJECTIVE: Neurologic involvement in Behçet disease (BD) is a rare manifestation. Herein, we aimed to evaluate the clinical features and treatment choices of neuro-Behçet (NB) patients. METHODS: There were records of 800 BD patients between 1998 and 2021. Fifty-five of the BD patients had NB and the files of these patients were retrospectively evaluated. Patients were grouped into three subgroups: 22 (40%) had non-parenchymal, 25 (45%) had parenchymal, and 8 (15%) had both parenchymal and non-parenchymal (mixed) involvement. RESULTS: Of the 55 patients, 32 were male. Twenty-six of the NB patients were diagnosed with BD simultaneously. The most common complaint was headache (n = 24, 44%). The most affected site was periventricular white matter (n = 21, 38%). All patients had received corticosteroids. Azathioprine (AZA; n = 39, 71%) was the most common immunosuppressive agent after corticosteroids, followed by cyclophosphamide (n = 16, 29%). CONCLUSION: Neurologic involvement is a rare complication of BD but is related to increased mortality and morbidity. Neurologic manifestations may be the initial symptom of BD, thus leading to diagnosis. Both neurology and rheumatology specialists should be aware of this rare condition.

Evaluation of cholinergic enzymes and selected biochemical parameters in the serum of patients with a diagnosis of acute subarachnoid hemorrhage.

Background: Spontaneous subarachnoid hemorrhage (SAH) is the most severe form of hemorrhagic stroke and accounts for 5-7% of all strokes. Several chemical enzymes and cytokines are thought to cause reactions that may affect the mortality and morbidity of SAH patients. This study aimed to examine the possible relationships between these parameters and the occurrence of SAH and the clinical-radiological parameters in patients with acute SAH. Methods: This study evaluated 44 patients, including 20 with SAH and 24 controls. We obtained blood from the patients and control groups, which was stored in heparinized tubes and used in determining tumor necrosis factor alpha (TNF-α), brain-derived neurotrophic factor (BDNF), acetylcholinesterase (AChE), caspase-3, and butyrylcholinesterase (BChE) enzymes. Results: TNF-α, BDNF, AChE, and BChE enzyme levels were not related to the Glasgow Coma scale (GCS) score in the patient group (p > 0.05), whereas higher enzyme levels of caspase-3 were associated with lower GCS scores (p < 0.05). The difference between the control and patient groups in terms of mean TNF-α levels was statistically significant (p < 0.01). The BDNF levels were statistically insignificant in the patient groups (p > 0.05). Caspase-3, AChE, and BChE levels were significantly different between the control and patient groups (p < 0.01). Conclusions: Our results may be valuable for predicting the prognosis, diagnosis, and follow-up of patients with SAH. However, further studies are required to elucidate the relationship between the clinical and radiological results in patients with SAH and certain enzymes, cytokines, and growth factors.

Neuroprotective effect of Capparis ovata Desf. var. palaestina Zoh. on H2O2­induced neurotoxicity in SH­SY5Y cells / Efecto neuroprotector de Capparis ovata Desf. var. palaestina Zoh. sobre la neurotoxicidad inducida por H2O2 en células SH ­SY5Y

The neuroprotective effect of flower and fruit parts of Capparis ovata Desf. var. palaestina Zoh. plant was investigated in H2O2-induced cytotoxicity in SH-SY5Y cells. The cells were treated with H2O2 alone or pretreated with flower (COMFL) and fruit extract (COMFR) of C. ovatavar. palaestina. MTT, xCELLigence, and qualitative and quantitative determination of phytochemical constituents in the extracts by LC-MS/MS methods were employed. COMFL and COMFR had a neuroprotective effect and this effect was stronger when the presence of oxidative stress. The mass spectrums revealed the presence of flavonoids and phenolic acid derivatives in the extracts. According to quantitative analyses, the main compounds were myristoleic acid, apigenin, caffeic acid, caffeic acid-3-glucoside, and 5-cynapoil quinic acid in both COMFL and COMFR and rutin was found in COMFL. The extracts could inhibit H2O2induced neuronal cell death which might be beneficial for the pretreatment of oxidative stress in neurodegenerative diseases.

Se investigó el efecto neuroprotector de flores y frutos de Capparis ovata Desf. var. palaestina Zoh sobre la citotoxicidad inducida por H2O2en células SH-SY5Y. Las células se trataron con H2O2solo o se pretrataron con extracto de flores (COMFL) y frutos (COMFR) de C. ovatavar. palaestina. Se emplearon MTT, xCELLigence y determinación cualitativa y cuantitativa de constituyentes fitoquímicos en los extractos mediante LC-MS/MS. COMFL y COMFR que tuvieron un efecto neuroprotector y este efecto fue mayor cuando hubo estrés oxidativo. Los espectros de masas revelaron la presencia de flavonoides y derivados del ácido fenólico en los extractos. Según los análisis cuantitativos, los compuestos principales fueron ácido miristoleico, apigenina, ácido cafeico, ácido cafeico-3-glucósido y ácido quínico 5-cinapoil tanto en COMFL como en COMFR y se encontró rutina en COMFL. Los extractos podrían inhibir la muerte celular neuronal inducida por H2O2, lo que podría ser beneficioso para el pretratamiento del estrés oxidativo en enfermedades neurodegenerativas.

Expanding the phenotype and genotype in Thauvin-Robinet-Faivre syndrome: A new patient with a novel variant and additional clinical findings.

Thauvin-Robinet-Faivre syndrome (TROFAS; OMIM #617107) is a rare autosomal recessive overgrowth syndrome characterized by generalized overgrowth, dysmorphic facial features, and delayed psychomotor development caused by biallelic pathogenic variants in the FGF-1 intracellular binding protein (FIBP) gene. To date, only four patients from two families have been reported. In this report, we present a 4-year-old male patient with generalized overgrowth and delayed developmental milestones consistent with this syndrome. In addition, he has unique features that were not reported in previous patients, including drooling, recurrent pulmonary infections, chronic pulmonary disease, hyperextensible elbow joints, hypoplastic nipples, unilateral cryptorchidism, and frequent spontaneous erections. We identified a homozygous, likely pathogenic variant, c.415_416insCAGTTTG (p.Asp139AlafsTer3), which causes a frameshift in the FIBP. Additionally, we identified a homozygous missense variant in the Toll-like receptor 5(TLR5) gene and a hemizygous missense variant in the chloride voltage-gated channel 4 (CLCN4) gene, with uncertain significance in either case. In this article, we set out the new observations and also discuss the frequency of the characteristic findings of the syndrome in the patients so far reported.

Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience.

OBJECTIVES: The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. MATERIALS AND METHODS: Our study included 23 solidorgan transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P <.05 was considered statistically significant. RESULTS: Mean age of solid-organ transplant recipients was 49.8 ± 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P = .224). Transplant recipients had greater requirements for nasal oxygen (P = .005) and noninvasive mechanical ventilation (P = .003) and had longer length of intensive care unit stay (P = .030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P = .439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P <.05). Secondary infections were major causes of mortality in transplant recipients. CONCLUSIONS: COVID-19 infection resulted in higher mortality in solid-organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.

Evaluation of the effectiveness of the Australian Mental Health Triage Scale in the emergency department: The case of Turkey.

PURPOSE: To examine the effectiveness of the Australian Mental Health Triage Scale(AMHTS) in Turkey. DESIGN AND METHODS: The study is a methodological and semiexperimental study. It was carried out with 30 emergency service nurses and 378 psychiatric patients at a university hospital. The validity and reliability of the AMHTS were examined. FINDINGS: The reliability of the AMHTS is good level (Cohen's κ = 0.631, p < 0.05). It is valid for making the patients' waiting time in triage more efficient(p < 0.05), and increases the nurses' ability to determine the treatment acuity. PRACTICE IMPLICATIONS: It is an important tool that affects the quality of emergency psychiatric care for nurses working in the emergency departments of general hospitals.

The golden spice curcumin in cancer: A perspective on finalized clinical trials during the last 10 years.

Curcumin, the key bioactive phytochemical present in turmeric (Curcuma longa L.), is the most studied natural compound in cancer. Preclinical studies (in vitro and in vitro) and clinical trials have demonstrated curcumin's effectiveness as an anti-inflammatory agent. The existing evidence supports that curcumin inhibits the proliferation of many types of cancer cells and can play an important role in cancer therapy. This study analyses the existing evidence in the literature on finalized clinical trials (2010-2020) related to the effect of curcumin and turmeric-derived products that focused on different types of cancers, such as chronic myeloid leukemia, multiple myeloma, prostate, colorectal and pancreatic cancer as well as cancer therapy-related complications, including oral mucositis and radiation dermatitis. Original English language articles and clinical trials published between 2010 and 2020 were searched using mainstream scholarly databases, such as PubMed, ScienceDirect, Google Scholar, and ClinicalTrials.gov. The keywords, such as "curcumin," "turmeric," "cancer," "anti-inflammatory," and "clinical trials," were used in various combinations. A total of 21 clinical trials were selected, reviewed, and included in this study. Sixteen out of 21 clinical trials were associated with the effectiveness of curcumin or turmeric on various types of cancer, and the other five clinical trials were related to the evaluation of the efficacy of curcumin or turmeric in relieving the side effects of cancer chemotherapy and radiotherapy. The emerging data from the clinical trials confirm that curcumin has the potential for cancer prevention and intervention. However, it is not yet clear whether long-term curcumin supplementation has similar benefits.

Detection of COVID-19 by Machine Learning Using Routine Laboratory Tests.

OBJECTIVES: The present study aimed to develop a clinical decision support tool to assist coronavirus disease 2019 (COVID-19) diagnoses with machine learning (ML) models using routine laboratory test results. METHODS: We developed ML models using laboratory data (n = 1,391) composed of six clinical chemistry (CC) results, 14 CBC parameter results, and results of a severe acute respiratory syndrome coronavirus 2 real-time reverse transcription-polymerase chain reaction as a gold standard method. Four ML algorithms, including random forest (RF), gradient boosting (XGBoost), support vector machine (SVM), and logistic regression, were used to build eight ML models using CBC and a combination of CC and CBC parameters. Performance evaluation was conducted on the test data set and external validation data set from Brazil. RESULTS: The accuracy values of all models ranged from 74% to 91%. The RF model trained from CC and CBC analytes showed the best performance on the present study's data set (accuracy, 85.3%; sensitivity, 79.6%; specificity, 91.2%). The RF model trained from only CBC parameters detected COVID-19 cases with 82.8% accuracy. The best performance on the external validation data set belonged to the SVM model trained from CC and CBC parameters (accuracy, 91.18%; sensitivity, 100%; specificity, 84.21%). CONCLUSIONS: ML models presented in this study can be used as clinical decision support tools to contribute to physicians' clinical judgment for COVID-19 diagnoses.

Synergistic Growth Inhibitory Effects of Eryngium kotschyi Extracts with Conventional Cytotoxic Agents: Cisplatin and Doxorubicin against Human Endometrium Cancer Cells.

BACKGROUND: Endometrial cancer is one of the most common types of cancer. For this reason, various studies have been carried out on its treatment and the effects of natural products on this disease. OBJECTIVES: This study aimed to examine the growth inhibitory effects of Eryngium kotschyi Boiss. ethyl acetate [EKE] and butanol [EKB] obtained from the main methanol [EKM] extract from the aerial parts on human endometrium carcinoma [RL95-2] cells and their synergistic effect with cisplatin or doxorubicin. METHODS: RL95-2 cells were treated with E. kotschyi extracts either alone or in combination with cisplatin or doxorubicin. The effects on cell growth were determined using the MTT assay and real-time cell analysis xCELLigence. RESULTS: The extracts demonstrated growth inhibitory activity, with a certain degree of selectivity against the RL95-2 cell line. Synergistic effects of EKE/cisplatin or doxorubicin at different concentration levels were demonstrated in RL95-2 cells. In some instances, the EKE/doxorubicin combinations resulted in antagonistic effects. The reduction level of cell viability was different and specific to each combination for the RL95-2 cell line. CONCLUSION: The growth inhibitory activity of cisplatin or doxorubicin, as a single agent, may be modified by combinations of the extracts and be synergistically enhanced in some cases. A significant synergistic effect of EKE on the RL95-2 cell line with cisplatin and doxorubicin was observed. This cytotoxic effect can be investigated in terms of molecular mechanisms. This study is the first of its kind in the literature. The mechanisms involved in this interaction between chemotherapeutic drugs and plant extracts remain unclear and should be further evaluated.

Cytotoxic evaluation and LC-MS/MS analysis of aerial parts of Eryngium kotschyi Boiss. grown in Turkey

Abstract Increasing biological activity and phytochemical investigations on Eryngium species showed its potential as pharmaceutical approach. Eryngium kotschyi Boiss. is one of the species of Eryngium genus and is endemic to Turkey. It is known that this plant is traditionally used in the South-western part of Turkey for the treatment of various diseases. This study focuses on cytotoxic activities of methanol extract and ethyl acetate, n-butanol and water sub-extracts from E. kotschyi in A549, COLO 205 and MDA-MB-231 cell lines by Sulforhodamin B assay and qualitative and quantitative determination of phytochemical constituents in active extract by LC-MS/MS. From the result of the study, it was seen that E. kotschyi ethyl acetate (EKE) sub-extract showed the strongest cytotoxic effect with the low IC50 values (50.00; 31.96 and 22.26 µg/mL in A549; COLO 205 and MDA-MB-231 cells at 48 h, respectively). Preliminary examination of the mass spectrums revealed the presence of 15 phytochemical compounds in active sub-extract and 7 of them was quantified. According to quantitative analyses the main compounds of EKE sub-extract were rosmarinic acid (485.603 µg/mgextract), chlorogenic acid (62.355 µg/mgextract) and caffeic acid (59.266 µg/mgextract). Moreover, this preliminary study on inhibitory activity of EKE sub-extract suggests further toxicologic investigations and detailed investigation on cytotoxic effect of various combinations of determined compounds

University Students' Attitudes About Violence Against Women in the Name of Honor.

OBJECTIVE: This research was conducted to determine attitudes of university students toward violence aganist women in the name of honor. METHOD: This cross-sectional and descriptive study was conducted with university students in Turkey. In addition to demographic information gathering, the following instruments were used to measure student attitudes: Introductory Information Form, Attitudes Toward Honor Scale, and Attitudes Toward Violence Against Women Scale. The high scores show the negative attitudes regarding the concept of honor. Analyses included descriptive statistics and analysis of variance with t tests, and alpha was set at 0.05. FINDINGS: Analyses were conducted on 1,038 surveys completed by students. Among the student participants, 686 (66.1%) were female, and the mean age was 20.51 ± 3.17 years. In all participants, 509 (49.0%) reported that they had been exposed to physical, verbal, sexual, or economic violence at least once in their lifetime; 151 (14.5%) had witnessed an honor killing in the social environment in which their families lived. The mean score of the Attitudes Toward Honor Scale (31.80 ± 15.84, max: 84) and Attitudes Toward Violence Against Women Scale (25.32 ± 9.36, max: 84) were found to be below the average. The mean scores on scales were found statistically significant (p < 0.05). CONCLUSION: University students do not approve of violence against women in the name of honor. However, some students, whose cultural characteristics were more dominant, tend to approve honor killings.

The relationship between university students' childhood traumas and their body image coping strategies as well as eating attitudes.

BACKGROUND: This study examined the relationship between university students' childhood traumas and their body image coping strategies as well as eating attitudes. METHODS: This cross-sectional, descriptive, and correlational study was conducted with 654 students who were selected from 6240 university students enrolled during the spring semester of the 2017-2018 academic year and determined using the stratified and simple random sampling method. Introductory Information Form, Childhood Trauma Questionnaire (CTQ), Body Image Coping Strategies Inventory (BICSI), and Eating Attitudes Test (EAT) were used. The reliability coefficients of the scales were 0.93, 0.82, and 0.85, respectively. The data were evaluated using number-percentage distributions and the relationships between the variables were examined using correlation analysis. RESULTS: Of the students, 56.7% were female. Their mean age was 20.71 ± 1.54. The mean CTQ score (41.14 ± 15.98), BICSI score (71.33 ± 10.32; max.: 116), and EAT score (19.61 ± 14.60) were below average. The study found a low, positive correlation between the CTQ total and subscale mean scores and the BICSI avoidance subscale mean score as well as the EAT mean score (p < 0.05). CONCLUSIONS: Few university students reported childhood traumas. Most students referred to positive coping using rational acceptance tendency against body image threats and problems, had low tendencies toward negative eating attitudes, and had no risk for an eating disorder. However, the students with a history of childhood trauma coped with body image threats and problems mostly using an avoidance tendency and had negative tendencies toward eating attitudes.

Relationship Between Caregivers' Care Burden and Their Social Functioning Perceptions Toward Addicted Patients: A Cross-Sectional Survey.

AIM: The aim of this study is to examine the relationship between social functioning perceptions of the caregivers toward their patients, and their perceived care burden. METHOD: The descriptive, cross-sectional and correlational study was carried out between September 2017-September 2019 using two measurement tools, in addition to an introductory information form: the Burden Interview and Social Functioning Scale The study was conducted with caregivers of the 76 addict outpatients and inpatients of the Alcohol and Substance Addiction Treatment Center of a university hospital in Turkey. The study data were evaluated using descriptive statistical analysis and correlation analysis. RESULTS: Of the caregivers, 69.7% were female and had a mean age of 43.32 ± 13.35 years; 52.6% and 47.4% of the all caregivers provided care to substance abusers and alcohol abusers, respectively. Of the addicted individuals receiving care, 78.9% were male, 60.5% were single, and 56.6% were unemployed. The mean age of patients was found to be 35.94 ± 11.75 years, and patients had been given treatment for an average of 7.56 ± 7.26 years. It was found that as caregivers' total mean Social Functioning Scale scores and mean subscale scores increased, their mean Burden Interview scores decreased (p > .05), though this value was not found to be statistically significant. CONCLUSION: These results are important to support not only the addicted individual but also their caregiver, and to conduct the related treatment and care holistically.

The effect of computed tomography on oxidative stress level and some antioxidant parameters.

BACKGROUND: X-rays are defined as ionizing radiation and hydrolyze the water, causing free radical formation. Oxidative stress is the damage that occurs in cells due to the lack of antioxidants, which detoxifies them, with the increased production of free radicals that occur during normal cellular metabolism. PURPOSE: To examine the acute effects of computed tomography (CT), i.e. ionizing radiation, on oxidative stress and antioxidant defense mechanisms. MATERIAL AND METHODS: The study included a total of 53 patients that were selected among the patients that underwent non-contrast full-body CT. Malondialdehyde (MDA) and reduced glutathione (GSH) levels and superoxide dismutase (SOD) and catalase (CAT) activities were investigated in blood samples taken from patients. RESULTS: The post-scan levels of MDA increased significantly while the post-scan levels of GSH, SOD, and CAT decreased significantly compared to their pre-scan levels. CONCLUSION: CT, which is a widely used X-ray imaging technique and has numerous known side effects, was found to increase the levels of MDA, which is an indicator of oxidative stress, and to decrease the levels of some antioxidants including GSH, SOD, and CAT.

Stigmatization and Social Functioning Levels of Patients With Alcohol Use Disorders.

AIM: The aim of this stu dy was to determine the levels of internalized stigma and social functioning of patients with alcohol use disorders. METHOD: The study is cross-sectional and descriptive. The data were collected between August 2017 and August 2018 using face-to-face interviews with 104 alcohol-dependent patients who were undergoing inpatient treatment. The data collection was done so through personal information forms, the Internalized Stigma of Mental Illness Scale (ISMIS), and the Social Functioning Scale (SFS). Descriptive statistics, t test, and correlation analysis were used in evaluating data. RESULTS: Analysis of the sociodemographic characteristics of the patients showed that the mean age was 47.28 ± 10.10 years and 92.3% of the patients were male. The mean age of patients when they first started drinking alcohol is 19.37 ± 6.25 years. It was determined that 85.5% of the patients were also cigarette smokers, 37.5% were previously treated because of alcohol dependence, and 34.6% are currently having legal problems. Patients' ISMIS mean score was 71.99 ± 13.78, and the mean scores of subscales were moderate. In SFS, the mean scores of the "preliminary social activity" and "leisure activities" subscales and the total scale scores were at a moderate level and those of the other subscales (social withdrawal, interpersonal functionality, independent competence, independent performance, job-profession) were below average. As the ISMIS mean score increases, the SFS subscales' mean scores decrease (p < .05). CONCLUSION: Alcohol-dependent patients negatively stigmatize themselves, and the functionality of their prosocial activity skills, along with their recreational activities, is inadequate. Furthermore, as ISMIS tends to increase, SFS (interpersonal functioning, prosocial activities, recreational activities, independence-performance) levels decrease.

Dexmedetomidine or midazolam in combination with propofol for sedation in endoscopic retrograde cholangiopancreatography: a randomized double blind prospective study.

INTRODUCTION: Interventional endoscopic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), often require sedation during the procedure. The most commonly used drugs for this purpose are midazolam and propofol, which are used as sedative and hypnotic agents with minimal analgesic potential. AIM: To compare the analgesic sedative effects of midazolam-propofol and dexmedetomidine-propofol combinations and their influence on hemodynamic and respiratory variables in patients undergoing ERCP. MATERIAL AND METHODS: Forty adult patients aged 20-78 and undergoing ERCP were randomized to two groups. Patients were premedicated with midazolam (0.05 mg/kg 10 min before the procedure) in group M and with dexmedetomidine (1 µg/kg for 10 min) in group D. Propofol was used for maintenance. The sedation level was monitored using the bispectral index (BIS) to maintain a score between 70 and 80. Hemodynamic and respiratory variables, recovery time and adverse events were recorded. RESULTS: The hemodynamic and respiratory variables were similar in both groups. Total propofol consumption was significantly lower in the dexmedetomidine group (208.5 ±80.0 vs. 154.5 ±66.7 mg; p = 0.011). The recovery period was shorter in group D (time to achieve the Aldrete score 9 was 9.4 ±2.1 vs. 6.6 ±1.1 min; p < 0.001). Changes in hemodynamic and respiratory variables and adverse events were not different between the two groups. CONCLUSIONS: We found a shorter recovery time and comparable sedative and adverse effects with the dexmedetomidine-propofol combination compared with the midazolam-propofol combination. Dexmedetomidine in combination with propofol may be a safe and useful alternative for sedation for ERCP patients.

Risk Factors for Urinary Tract Infection After Kidney Transplant: A Retrospective Analysis.

OBJECTIVES: Urinary tract infections are the most common type of infections in kidney transplant recipients. They are also important factors for increased morbidity and mortality. The aims of this study were to evaluate the number of urinary tract infections, to identify possible donor/receiver-based risk factors, and to evaluate the impact of these infections on graft function. MATERIALS AND METHODS: Medical records of patients who had undergone kidney transplant between 2010 and 2017 were retrospectively analyzed. RESULTS: Our study included 145 patients (49 women [33.8%] and 96 men [66.2%]), with mean age of 35.2 ± 12.4 years. There were 105 episodes of urinary tract infections in 55 of 145 patients (37.9%) during the first year after transplant. Female sex (P = .001), glomerulonephritis as primary kidney disease (P = .04), pretransplant diabetes (P = .05), and presence of ureteral stent (P = .03) were significant risk factors for the development of urinary tract infections. The most frequent pathogens identified were Escherichiacoli and Klebsiella pneumoniae. Mean glomerular filtration rate t 12 months was significantly lower in patients with urinary tract infection than in patients without infection (80 ± 25 vs 68 ± 28 mL/min; P = .006). CONCLUSIONS: In kidney transplant recipients, urinary tract infections are common complications and have negative outcomes on graft function. These infections remain an important disease that requires frequent investigations and new ways of approach for prevention.

Change of the levels of trace elements and heavy metals in threatened abortion.

BACKROUND: This study aimed to investigate the impact of changes in the serum levels of trace elements and heavy metals in threatened abortion, which is a common complication in early pregnancy. Earlier studies have shown that changes in the serum levels of some trace elements and increased serum concentrations of heavy metals are associated with spontaneous abortion; however, this relationship has not been fully clarified. METHODS: The patient group consisted of 45 pregnant women diagnosed with threatened abortion. There were 40 healthy nonpregnant women in the control group. Blood samples were obtained from the patients and the healthy controls, and the concentrations of serum trace elements and heavy metals were measured using atomic absorption spectrophotometry. RESULTS: Statistically significant decreases were found in the serum zinc (Zn), iron (Fe), magnesium (Mg) and manganese (Mn) levels, and significant increases were found in the serum copper (Cu), cadmium (Cd) and lead (Pb) levels in cases of threatened abortion in comparison to the controls (p < 0.001). However, there was no difference between the groups in terms of the serum cobalt (Co) levels (p > 0.001). CONCLUSION: Changes in the balance of some essential trace elements (especially decreases in Fe and Zn) and elevated concentrations of some toxic heavy metals in the blood may be important diagnostic and prognostic parameters for threatened abortion.