High frequency of transient congenital hypothyroidism among infants referred for suspected congenital hypothyroidism from the Turkish National screening program: thyroxine dose may guide the prediction of transients.

PURPOSE: We aimed to determine the frequency of transient congenital hypothyroidism (TCH) in 17 participating centers in Türkiye, evaluate the etiological distribution in permanent congenital hypothyroidism (PCH) cases, and investigate the role of laboratory and clinical findings in predicting TCH. METHODS: This retrospective observational multicenter study included patients from 17 pediatric endocrinology centers identified by "National Newborn Screening Program" (NNSP) who were born in 2015 and followed for 6 years. Demographic, clinical, and laboratory information of the cases were compiled through the database http://cedd.saglik-network.org (CEDD-NET). RESULTS: Of the 239 cases initially treated for CH, 128 (53.6%) were determined as transient in whom a trial of levothyroxine (LT4) withdrawal was performed at a median age of 36 (34-38) months. Among the patients with PCH (n = 111), thyroid dysgenesis was diagnosed in 39.6% (n = 44). The predictive factors for TCH were: LT4 dose at the withdrawal of treatment, and initial newborn blood screening (NBS)-TSH level. Based on the receiver operating characteristic (ROC) curve analysis to predict optimal cut-offs for TCH predictors, LT4 dose < 2.0 µg/kg/day at treatment discontinuation was predictive for TCH and was associated with 94.5% specificity and 55.7% sensitivity, with an area under the curve (AUC) of 0.802. The initial NBS-TSH level value < 45 µIU/mL was predictive for TCH with 93.1% specificity and 45.5% sensitivity, with an AUC of 0.641. In patients with eutopic thyroid gland only LT4 dose < 1.1 µg/kg/day at withdrawal time was predictive for TCH with 84.7% sensitivity and 40.4% specificity, with an AUC of 0.750. CONCLUSION: According to our national follow-up data, the frequency of TCH was 53.6%. We determined the LT4 dose < 2.0 µg/kg/day at discontinuation of treatment and the initial NBS-TSH level < 45 µIU/mL as the best cut-off limits to predict TCH.

Satisfactory medium-long term patient reported outcomes after laparoscopic single-mesh sacrohysteropexy.

Background: There is scarce information on the effectiveness of the laparoscopic single mesh sacrohysteropexy (smSHP). Attachment of a single sheet of flat mesh posteriorly to the cervix provides less mesh use and a less invasive distal mesh fixation. Objectives: To assess medium to long-term follow-up results of patients who underwent laparoscopic smSHP utilising a less invasive technique with single sheet flat mesh. Materials and Methods: In the present retrospective cohort study, the data of 71 women who underwent laparoscopic smSHP for apical uterine prolapse with or without colporrhaphy (anterior and/or posterior) at the urogynaecology unit of a university hospital between January 2008 and January 2020 was reviewed. Data was collected on demographics, presenting symptoms, preoperative findings, surgery, and postoperative outcomes. Main Outcome Measures: Medium to long-term patient-reported outcomes. Results: The median age of the study population was 44 years. Median follow-up duration was 5 years (1-12). Symptomatic recurrence over time and repeat surgery rates were 13.1% and 3.1% respectively. Comparison of the pre-operative and medium to long-term evaluation scores of the pelvic floor distress inventory-20 (PFDI-20) and assessment of the patient global impression of improvement (PGI-I) revealed long-standing improvement in pelvic floor dysfunction. Conclusions: Laparoscopic smSHP appears to be successful and safe with low recurrence and complication rates and provides satisfactory patient reported outcomes. What's new?: Medium to long-term patient-reported outcomes based on PFDI-20 and PGI-I surveys are satisfactory following smSHP.

Tromethamine and dodecanol appear to be the major secondary metabolites of Streptomyces decoyicus M.

An isolate of Streptomyces decoyicus M* (code of the isolate) was identified by the sequencing of 16S rRNA gene. It was grown on solid media and secondary metabolites were extracted with n-butanol. The extract was dried and run in a sodium dodecyl sulphate-polyacrylamide gel (SDS-PAGE, 10%). Two main bands obtained were sliced and the metabolites were regained in n-butanol. These two samples were then identified by gas-chromatography-mass spectrometry (GC-MS), and Fourier-transform infrared spectroscopy (FT-IR). The results demonstrated that tromethamine- and 1-dodecanol were the main constituents (band 1: 61% and 17.7%; band 2: 41% and 54%, respectively). This finding maintained that the isolate of Streptomyces decoyicus produced high amounts tromethamine- and 1-dodecanol under the conditions investigated.

Heavy metal and essential elements in beers from turkey market: A risk assessment study.

In this study, the level of arsenic (As), lead (Pb) and cadmium (Cd) and also essential elements in beer samples consumed in Turkey were investigated using the inductively coupled plasma mass spectrometry (ICP-MS) method. The heavy metal-induced non-carcinogenic and carcinogenic risks were calculated. For essential elements, the calculated estimated daily intake of iron (Fe), copper (Cu), selenium (Se) and cobalt (Co) from beer consumption were compared with their toxicity reference values. Tukey post-hoc test showed that As was found at a significantly higher level when compared to Pb. Also, a significant correlation was found between As level and alcohol by volume percent. All samples had a hazard quotient and hazard index <1, indicating no non-carcinogenic risk from exposure to single or multiple heavy metals. Some samples exceeded the threshold limit of acceptable cancer risk for As in the high beer consumer group. This assessment showed that in addition to health implications based on the alcohol content of beer, there might be a carcinogenic risk associated with the heavy metals content of these beverages.

Expressions of homeobox, collagen and estrogen genes in women with uterine prolapse.

OBJECTIVE: Genetic contribution is thought to be involved in the pathophysiology of pelvic organ prolapse (POP). We aimed to study the gene expression profiles of the genes HomeoboxA11 (HOXA11), HomeoboxA13 (HOXA13), Collagen Type I (COL1A), Collagen Type III (COL3A), estrogen receptor genes (ESR1 and ESR2) of round (RL) and uterosacral ligaments (USL) in postmenopausal women with uterine prolapse. STUDY DESIGN: Gene expressions of 32 postmenopausal women with prolapse were analysed according to gene expressions of 8 postmenopausal women without prolapse. Quantitative real-time PCR (qRT-PCR) method was used for the detection of expression levels of the genes. Student's t-Test and Mann-Whitney U test were used for statistical analysis. RESULTS: In the USL specimens of all women with uterine prolapse HOXA13 and ESR1 gene expressions were decreased compared to controls (0.5 fold, p = 0.04 and 0.82 fold, p = 0.04, respectively). In the RL specimens, ESR2 gene expression was decreased 0.7 fold in women with prolapse when compared to controls (p = 0.04). In the USL specimens of women with advanced stages of prolapse (stage ≥3), HOXA13 and COL3A gene expressions were decreased compared to controls (0.44 fold, p = 0.043 and 0.39 fold, p = 0.045, respectively). In the RL specimens, ESR2 gene expression was decreased 0.65 fold in women with prolapse when compared to controls (p = 0.052). CONCLUSION: The significant decrease in the expression of the genes HOXA13, COL3A in the USL and ESR2 in the RL especially in advanced stages of prolapse, implicate that these gene expressions may play a role in the development of uterine prolapse.

Improving the rhinomanometry technique using benzoin tincture.

OBJECTIVE: In order to achieve a faster and more reliable anterior rhinomanometric evaluation, nasal skin was prepared using benzoin tincture solution, which provides simpler and better adhesion of the foam tape to the nasal skin. METHOD: Two consecutive anterior rhinomanometry measurements were made, one with and one without benzoin tincture application. RESULTS: The average time taken to perform classic foam tape anterior rhinomanometry without benzoin tincture application was 281.32 seconds, and the average coefficients of variation for the right and left passages were 7.48 and 7.59 per cent, respectively. When benzoin tincture was used, the average time taken for completion of the tests was 121.24 seconds, and the average coefficients of variation for the right and left passages were 2.17 and 2.32 per cent. CONCLUSION: The use of benzoin tincture to clean the nasal skin before placing foam tape shortens the procedure duration and significantly increases test reliability.

Ambulatory urodynamic monitoring of women with overactive bladder syndrome during single voiding cycle.

OBJECTIVE(S): To present data of standardized ambulatory urodynamic monitoring (AUM) performed in women with overactive bladder syndrome (OAB) and to evaluate the relevance of AUM data with clinical findings of the patients. STUDY DESIGN: Records of women with symptoms of OAB were retrospectively reviewed (n=249). Of women fulfilling the Overactive Bladder Awareness Tool (OAB-V8) with a score ≥8 and the 3-day voiding diary (VD) with a frequency >7/day (n=167), those who underwent urodynamic investigation were selected (n=76). The data of this study were retrieved from the records of Ankara University Cebeci Hospital and based on the AUM findings of single voiding cycle of women with OAB. AUM, which is among the institutionally approved primary urodynamic investigation methods, is performed with LUNA ambulatory monitoring recorder (MMS™) in the clinical setting with a standardized technique, in reproducing lower urinary tract symptoms of women since 2011. The relationship of the urodynamic data with the clinical findings were evaluated. RESULTS: AUM traces of women (n=76) with OAB revealed 63.1% DO, 64.4% urgency and 77.7% urinary incontinence of which were 14.4% urgency urinary incontinence (UUI), 25% stress urinary incontinence (SUI) and 38.1% mixed urinary incontinence (MUI). OAB patients with DO reported more urinary incontinence episodes/day, nocturia and mixed urinary incontinence in the voiding diary (p<0.04) and had significantly higher irritative symptom bother reflected by the questionnaires (p<0.04). Women with DO were more likely to be postmenopausal (p=0.02) and were found to have more urgency (p<0.001), urgency episodes (p=0.05) and incontinence (urge and mixed) (p<0.001). However, no association was found between the extent of pelvic organ prolapse and the presence of DO. CONCLUSIONS: AUM performed with a standardized technique during single voiding cycle seems to be a reliable method in reproducing symptoms of women with OAB. It provides both clinically relevant findings and objective documentation of urgency which is the main symptom for OAB. The detection of DO according to the ICS definition were also found to be concordant with urodynamicaly observed urgency and urinary incontinence. Objective and subjective clinical findings of OAB were found to be more severe in women with DO.

Effects of curcumin on methyl methanesulfonate damage to mouse kidney.

Methylmethane sulfonate (MMS) is an alkylating agent that may react with DNA and damage it. We investigated histological changes and apoptosis caused by MMS and the effects of curcumin on MMS treated mouse kidneys. Twenty-four mice were divided into four equal groups: controls injected with saline, a group injected with 40 mg/kg MMS, a group injected with 40 mg/kg MMS and given 100 mg/kg curcumin by gavage, and a group given 100 mg/kg curcumin by gavage. MMS caused congestion and vacuole formation, and elevated the apoptotic index significantly, but had no other effect on kidney tissue. Curcumin improved the congestion and vacuole formation caused by MMS and decreased the apoptotic index. Curcumin administered with MMS appears to decrease the deleterious effects of MMS on the kidney.

Growth and characterization of CuO nanostructures on Si for the fabrication of CuO/p-Si Schottky diodes.

CuO interlayers in the CuO/p-Si Schottky diodes were fabricated by using CBD and sol-gel methods. Deposited CuO layers were characterized by SEM and XRD techniques. From the SEM images, it was seen that the film grown by CBD method is denser than the film grown by sol-gel method. This result is compatible with XRD results which show that the crystallization in CBD method is higher than it is in sol-gel method. For the electrical investigations, current-voltage characteristics of the diodes have been studied at room temperature. Conventional I-V and Norde's methods were used in order to determine the ideality factor, barrier height, and series resistance values. It was seen that the morphological and structural analysis are compatible with the results of electrical investigations.

Mean platelet volume in patients with nasal polyposis.

OBJECTIVE: To investigate whether mean platelet volume (MPV) levels rise in patients with nasal polyposis (NP) and whether higher MPV levels are correlated to the extension of polyps in these patients. MATERIALS AND METHODS: This study included 50 patients with NP and 40 age- and sex-matched healthy subjects as controls. The Lund-Mackay staging system was used to assess paranasal sinus computed tomography (CT) scans in patients with NP, and paranasal sinus CT scores were recorded. MPV was measured in a blood sample collected in EDTA tubes and was also used for whole blood counts in all patients. The Mann-Whitney U-test and Student's t-test were used to compare the results of the two groups. RESULTS: NP patients had higher MPV levels than the control group (9.60 +/- 1.06 fl and 8.77 +/- 0.88 fl, p < 0.001 respectively). However, there was no significant correlation between MPV and paranasal sinus CT scores. CONCLUSION: To our knowledge, this is the first study to investigate MPV levels in patients with NP. Our results suggest that MPV, a determinant of platelet activation, is elevated in patients with NP. Increased platelet activation may be related to an increase in cardiovascular risk in patients with NP.

Evaluation of the risk factors for acute occupational hand injuries.

OBJECTIVES: To evaluate the effect of demographic and occupational factors on the severity of the acute occupational hand injuries. METHODS: Patients with acute hand injuries presenting to the emergency department of the Ege university hospital between 01.08.2008 and 27.02.2009 were included. A questionnaire investigating demographic and occupational factors of the patients and their injuries was filled out for each patient. Modified Hand Injury Severity Score (MHISS) was used to assess the severity of the injury. RESULTS: A total of 144 subjects were included. Forty-three patients had occupational hand injuries. Age at injury, occupation, and main earning status did not alter the MHISS score significantly. Also, the mechanism of injury, occupational experience, timing of the injury, glove use, safety training did not have a significant effect on the injury severity. The injury pattern was found to have a statistically significant effect on the MHISS score. CONCLUSION: The potentially modifiable factors such as the working conditions, safety training and use of gloves are important in the etiology of occupational acute hand injury. Most probably, in this study the size of the sample was not large enough to be able to demonstrate any relation between these and the injury severity. However, attempts to modify these factors by various strategies may reduce the incidence of acute hand injury at work. Precautions and widespread educational programs can prevent occupational acute hand injury.

Evaluation of adrenocortical function in 3-7 aged asthmatic children treated with moderate doses of fluticasone propionate: reliability of dehydroepiandrosterone sulphate (dhea-s) as a screening test.

BACKGROUND: Inhaled corticosteroids (ICS) are the first-line therapy in the treatment of persistent asthma. At medium to high doses and prolonged usage, ICS can supresss the hypothalamic-pituitary-adrenal axis. Dehydroepiandrosterone sulphate (DHEA-S) is a corticotropin-dependent adrenal androgen precursor that is supressible in patients treated with ICS. OBJECTIVES: To evaluate the adrenal axis in asthmatic children treated with moderate doses of fluticasone propionate and to evaluate the DHEA-S as a possible marker for adrenal axis in preadrenarchal children. METHODS: Twenty-eight children with persistent asthma with a mean age of 4.4 years (median 4.2; range 2.5-7.1) on long term treatment (mean 6.16; median 6; range 4.5-9 months) with moderate doses (mean 250; median 253; range 158-347 (g/m(2)/day) of inhaled fluticasone propionate were evaluated with low-dose ACTH stimulation test to assess adrenal function, and DHEA-S levels were compared with the results. RESULTS: One out of 28 patients (3.57%) demonstrated an abnormal cortisol response to low-dose ACTH test. There was no correlation between DHEA-S and peak cortisol, morning cortisol and fasting blood glucose levels. However, mean inhaled corticosteroid dosages were inversely correlated with the DHEA-S. CONCLUSIONS: In most of the children with persistent asthma, mild to moderate fluticazone propionate doses supress the hypothalamic-pituitary-adrenal axis rarely. Chronic moderate doses of ICS may suppress adrenal androgen levels without supression of cortisol production. DHEA-S levels may be used as a practical method to follow adrenal functions and may be an earlier indicator of adrenal dysfunction in children.

Hyperparathyroidism secondary to maternal hypoparathyroidism and vitamin D deficiency: an uncommon cause of neonatal respiratory distress.

A 4-day-old neonate presented with respiratory distress owing to chest wall deformity associated with metabolic bone disease. He was found to have congenital hyperparathyroidism and his mother was suffering from post-surgical hypoparathyroidism and vitamin D deficiency. The patient was given calcium lactate and maintenance doses of vitamin D. The respiratory distress subsided, the parathyroid hormone level returned to normal and by 4 weeks of age bone mineral content had improved. Congenital hyperparathyroidism should be considered in neonates presenting with respiratory distress and chest deformity.

Determination of optimum operating conditions for industrial dye wastewater treatment using adaptive heuristic criticism pH control.

For a pilot-scale application, pH control in the treatment of highly contaminated dye industrial wastewater containing metallic compounds as the main pollutants has been investigated with a method using adaptive heuristic criticism control (AHCC). Subsequent experimentation on between 12 and 18 l of the wastewater was carried out using statistical experimental design methodology to evaluate the effects of three critical factors: slaked lime (calcium hydroxide, Ca(OH)(2)) concentration, iron chloride (FeCl(3)) concentration and wastewater volume. With these critical factors, the wastewater treatment process is modeled as an appropriate quadratic cost function of the turbidity of the clarified water. The model is optimized with Rosenbrock's method. Response surface topology of the wastewater treatment is given in terms of optimal concentrations of lime water and FeCl(3) and optimal wastewater volume at pH 11.

Imaging in mediastinitis: a systematic review based on aetiology.

Mediastinitis refers to inflammation of the tissues located in the middle chest cavity. It can be secondary to infectious or non-infectious causes and depending on the aetiology may be acute or chronic. The majority of cases of acute mediastinitis are secondary to oesophageal perforation and open chest surgery. Less common causes include tracheal, bronchial perforation or direct extension of infection from adjacent tissues. Chronic or slowly developing mediastinitis mostly arise from tuberculosis, histoplasmosis, other fungal infections, cancer, or sarcoidosis. In a minority of cases the aetiology is lymphatic obstruction or an autoimmune disease. Radiological imaging plays an essential role in the diagnosis and therapeutic approach to mediastinitis. Generally, the initial radiological work-up includes radiographic studies either with or without contrast material. However, conventional chest radiography may be misleading in the diagnosis of mediastinitis. Cross-sectional imaging techniques are generally required for diagnosis and evaluation of the site and extent of mediastinal involvement. Computed tomography and magnetic resonance imaging may also guide the choice of the optimal therapeutic approach.

Retroperitoneal fibrosis caused by pergolide in a patient with Parkinson's disease.

Retroperitoneal fibrosis (RPF) is an uncommon disorder that may cause ureteric obstruction with renal damage. Pergolide, a dopaminergic agonist used in the treatment of Parkinson's disease, has rarely been related to the development of RPF. We report on a 78-year-old woman with Parkinson's disease who presented with hydroureteronephrosis and developed RPF and serosal fibrosis during treatment with pergolide. Following discontinuation of pergolide therapy and placement of a double-J stent, her renal function improved. Inflammatory markers returned to normal limits within two months and the retroperitoneal fibrotic mass became smaller.

Bacteriocin diversity in Bacillus sphaericus.

Nondenaturing polyacrylamide gel electrophoresis revealed the presence of diversity among bacteriocins produced by strains of Bacillus sphaericus. Bacteriocin bands of six strains (pathogenic and non pathogenic) were found to be located just below the stacking gel. However, in two other strains (1 pathogenic and 1 collection strain) more than one protein band with bacteriocin activity were seen in the middle of resolving gel. In bacteriocin-treated cultures, electron-microscopy studies revealed the growth of lysedswollen ghost cells, and loss of viability among sensitive strains.

The effects of Rumex patientia extract on rat liver and erythrocyte antioxidant enzyme system.

The aqueous extract from the roots of Rumex patientia L. (Polygonaceae) (D-1) was investigated for its effects on rat liver and erythrocyte antioxidant enzyme systems and lipid peroxidation. Measurements of the GSH-Px, SOD and CAT activities, and MDA levels of liver and erythrocytes in D-1 administered animals showed that there was an increase in GSH-Px and SOD activities when compared to that of controls. No significant decrease was observed in catalase activity and no changes in malondialdehyde levels were observed.

Another face of mirror-image artifact.

The physics of ultrasound and mechanisms of artifacts are well-known. In this report, an unusual manifestation of mirror-image artifact (MIA) that is completely different from the real image of the structure, demonstrated during a routine abdominal ultrasonographic examination, is described. There have hitherto been no reports on the ultrasonographic appearance of such a MIA.