Is increased activator protein 1 in cerebrospinal fluid as a potential biomarker that distinguishes idiopathic intracranial hypertension from multiple sclerosis?

OBJECTIVES: To distinguish whether idiopathic intracranial hypertension (IIH) is a condition predisposing to multiple sclerosis (MS) or an isolated disease, the current gene transcription factor Activator Protein-1 (AP-1) was evaluated with its potential to differentiate both diseases. BACKGROUND: The aim of this study was to investigate the use of AP-1 as biomarkers for the discrimination of IIH and MS. METHODS: AP-1, TNF-α, and IL-6 protein values in the CSF of the cases were evaluated by the ELISA method. The numerical measures of the groups and the ability of AP-1 to distinguish the groups were analyzed with the ROC curve. RESULTS: There was no difference between the groups in CSF TNF-α, IL-6, CSF, and serum biochemistry analyses. However, it was determined that the AP-1 concentration (pg/ml) was significantly higher in the IIH group, the sensitivity of AP-1 in separating those with IIH was 75%, and the specificity in separating those with MS was 60% in those with an AP-1 concentration of 606.5 and above. CONCLUSION: According to our results, the fact that CSF TNF-α and IL-6 values did not differ in IIH compared to MS revealed that IIH could not methodologically control MS, and AP-1 was a supportive parameter in differentiating both diseases (Tab. 2, Fig. 1, Ref. 31).

Clinicopathological profile of peritoneal tuberculosis and a new scoring model for predicting mortality: an international ID-IRI study.

Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data. In this study, 208 patients with TBP were included. Mean age of TBP cases was 41.4 ± 17.5 years. One hundred six patients (50.9%) were females. Nineteen patients (9.1%) had HIV infection, 45 (21.6%) had diabetes mellitus, 30 (14.4%) had chronic renal failure, 12 (5.7%) had cirrhosis, 7 (3.3%) had malignancy, and 21 (10.1%) had a history of immunosuppressive medication use. A total of 34 (16.3%) patients died and death was attributable to TBP in all cases. A pioneer mortality predicting model was established and HIV positivity, cirrhosis, abdominal pain, weakness, nausea and vomiting, ascites, isolation of Mycobacterium tuberculosis in peritoneal biopsy samples, TB relapse, advanced age, high serum creatinine and ALT levels, and decreased duration of isoniazid use were significantly related with mortality (p < 0.05). This is the first international study on TBP and is the largest case series to date. We suggest that using the mortality predicting model will allow early identification of high-risk patients likely to die of TBP.

The Effects of Long-term Growth Hormone Treatment on Ocular Findings.

PURPOSE: This study aimed to examine the long-term changes in anterior chamber depth (ACD), central corneal thickness (CCT), axial length (AxL), peripapillary retinal nerve fibre layer thickness (RNFLT), peripapillary ganglion cell layer - inner plexiform layer (GCL-IPL) thickness, and peripapillary choroidal thickness (ChT) after rhGH replacement treatment in paediatric patients with IGHD, compared to healthy controls. METHODS: Twenty-two children with IGHD including 12 girls and 10 boys were enrolled in the study group, and 30 (16 girls, 14 boys) healthy children composed the control group. A detailed ophthalmological examination was performed for each participant. ACD, CCT, AxL, peripapillary RNFLT, GCL-IPL thickness and ChT measurements were performed before the rhGH replacement treatment and in the 12th month of the post-treatment period, as well as the corresponding visits in the control group. AxL ultrasound pachymetry (CCT), peripapillary RNFL thickness, peripapillary RNFLT, GCL-IPL thickness, and peripapillary ChT parameters were measured by spectral-domain optical coherence tomography. RESULTS: The mean age of the groups were similar (p = 0.143). 12-month CCT, ACD, and AxL measurements of the study group showed significantly higher results than the pre-treatment measurements (p = 0.005, p = 0.024, and p = 0.002, respectively). Similarly, the mean RNFLT and ChT measurements of the study group obtained from all sectors were significantly higher in the 12th-month visit (p < 0.001 for both) other than the RNFLT, and GCL-IPL thickness measurements (p > 0.05 for all). However, all these parameters were similar at pre- and post-treatment visits in the control group (p > 0.05 for all). The mean pre-treatment values of all these parameters were significantly lower in the study group compared to the control group (p < 0.05 for all), other than the RNFLT, GCL-IPL thickness measurements (p > 0.05 for all), while the mean post-treatment values of all these parameters in both groups were similar at month 12 (p > 0.05 for all). CONCLUSION: GH replacement treatment in childhood may play an important role in the development of the neural retina and can be effective on the anterior segment, RNFLT and ChT measurements.

Anxiety and Depression among People Living with HIV During the COVID-19 Pandemic: A Face-to-Face Survey from Turkey.

BACKGROUND: During the COVID-19 pandemic, there have been some difficulties in the routine care of people living with HIV (PLWH). SUBJECTS AND METHODS: We aimed to evaluate the impact of COVID-19 on mental health of PLWH and their use of health services. This study was conducted using the face-to-face interview method in the outpatient clinic of a university hospital, between 01.09.2020 and 30.11.2020. Hospital Anxiety and Depression Scale and survey instrument designed by the researchers investigating socio-demographic data and access to health services were used. RESULTS: The study included 217 patients, 91.7% (n=199) of whom were male. All of the patients were postponed their hospital appointments, 60.8% were concerned about not being able to contact their physician and 53% had concerned about being stigmatized if they went to the hospital. Of the participants, 27.6% had depression, 12.9% had anxiety and 8.3% had both depression and anxiety. Low income, job loss, and fear of being stigmatized were associated with depression and anxiety. Lower level of education, discontinuation of medications and lack of opportunity to work remotely were associated with depression, while history of psychiatric illness, worry about not being able to contact their physician and cessation of antiretroviral therapy were associated with higher anxiety levels. CONCLUSION: It is important to develop strategies ensuring the continuity of care for PWLH and identify and support those with a higher mental health impact.

Clinical significance of serum lncRNA H19, GAS5, HAR1B and linc01783 levels in Parkinson's disease.

Background and purpose:

Long noncoding RNAs (lncRNAs) are highly expressed in the brain and alterations in their levels have been shown in many neurodegenerative disorders. Evidence has shown that lncRNAs play role in the onset and progression of Parkinson’s disease (PD) and it can be used as a potential therapeutic target. Our purpose was to detect whether the serum levels of four candidate lncRNAs H19, GAS5, HAR1B and LINC01783 are related with the clinical findings and treatment of PD or not. 

83 patients and 50 healthy controls were included in this study. We assessed how severe the disease is, by using Hoehn Yahr (HY) staging and Unified PD rating scale (UPDRS). Venous blood samples were taken from the participants. Serum samples were centrifuged and stored at -80°C until analysis. Expression levels of these lncRNAs were analyzed by a real-time PCR instrument after RNA isolation and complementary DNA synthesis in the laboratory.

There was no significant difference between PD patients and healthy controls in these lncRNAs’ serum levels. Just as sociodemographic characteristics, also onset type and right or left predominance of the disease, its duration and treatment did not differ in lncRNA levels. Solely, there was a significant negative correlation between GAS5 and HY and UPDRS scores. Patients with family history of PD had significantly higher levels of LINC01783.

Serum lncRNA GAS5 level may be a possible biomarker for disease severity in PD patients. 

Microorganisms isolated from the bile of the patients who have undergone cholecystectomy and their antibiotic resistance pattern: multicenter prospective study.

BACKGROUND: Gallbladder and biliary tract infections are diseases with high mortality rates if they are not treated properly. Microbiological evaluation of perioperatively collected samples both ensures proper treatment of patients and guides empirical treatment due to the determination of microorganism susceptibility. AIMS: This study aimed to isolate the microorganisms in bile cultures from patients who underwent cholecystectomy and to determine sensitivity results of these microorganisms. METHODS: This study was a multi-center and prospective design, included 360 patients, and was performed between 2019 and 2020. Culture results of bile taken during cholecystectomy were evaluated. RESULTS: Bacterial growth was found in the bile cultures of 84 out of 360 (23.3%) patients. Patients were divided into two groups according to whether they had risk factors for resistant microorganisms or not. While Escherichia coli (n = 11, 13%), Enterococcus spp. (n = 8, 9.5%), and Enterobacter spp. (n = 4, 4.7%) were detected most frequently in patients without risk. Staphylococcus spp. (n = 17, 20.2%), Enterococcus spp. (n = 16, 19%), and E. coli (n = 8, 9.5%) were the most frequently found microorganism at-risk patients. In multivariate analysis, bile culture positivity was found higher in patients who had history of biliary disease (p = 0.004), operation performed concurrently with a cholecystectomy (p = 0.035), and high rate of polymorphonuclear leukocytes (PNL) in total leukocyte count (p = 0.001). CONCLUSIONS: Our study shows that when starting empirical antibiotic treatment for bile ducts, whether patients are at risk for the development of resistant bacterial infection should be evaluated after which antibiotic selection should be made accordingly.

The Correlation of Histopathologic Parameters With Mismatch Repair Protein-deficient Subgroups and MLH1 Methylation in Endometrial Carcinomas.

There are limited data regarding the correlation of clinical and pathologic parameters with mismatch repair (MMR) protein-deficient subgroups and methylation status. In this study, we analyzed the status of MMR proteins in resection specimens of 198 consecutive endometrial carcinomas and the methylation status in tumors with MLH1 and PMS2 deficiency. We, therefore, assessed the correlation of clinical and pathologic parameters with MMR protein-deficient subgroups. Univariate analysis revealed that deeper myometrial invasion and the presence of tumor-associated lymphocytes were more frequently observed in tumors with MMR protein deficiency ( P =0.023 and 0.001, respectively). The multivariate logistic regression analysis revealed that only the presence of tumor-associated lymphocytes was significantly associated with MMR protein deficiency ( P =0.002, odds ratio=2.674, 95% confidence interval=1.418-5.045). We also compared MLH1 and PMS2 deficiency with other protein deficiency regarding clinical and pathologic parameters. Furthermore, we compared MLH1 methylated tumors with MMR protein-deficient nonmethylated tumors regarding clinical and pathologic parameters. MLH1 was methylated in 51 of 54 tumors with MLH1 and PMS2 deficiency. In univariate analysis, a larger tumor size was significantly associated with MLH1 and PMS2 deficiency and with MLH1 methylation ( P =0.004 and 0.005, respectively). The multivariate logistic regression analysis revealed that a larger tumor size was significantly associated with MLH1 and PMS2 deficiency and MLH1 methylation ( P =0.002, odds ratio=14.222, 95% confidence interval=2.560-79.026, P =0.008, odds ratio=22.222, 95% confidence interval=2.220-222.395, respectively). Our results showed a slightly higher rate of MLH1 and PMS2 deficiency (34.3%) than in previous studies. This may likely be due to ethnic differences in frequency of various mutations.

Comparison of decision-making under ambiguity in patients with temporal lobe and frontal lobe epilepsy.

OBJECTIVE: The effect of the frontal lobe on cognitive functions is a subject that has been studied frequently. However, cognitive impairments that can be seen in frontal lobe epilepsy are less addressed. In previous studies on decision-making disorders in patients with epilepsy, patients with temporal lobe epilepsy (TLE) were frequently studied, and it was reported that decision-making disorders could be encountered in this patient group. In this study, we aimed to compare the decision-making performance of patients with cryptogenic frontal lobe epilepsy (FLE) and TLE in ambiguous situations. METHODS: Twenty patients with TLE (mean age: 34.10 ±â€¯11.71 years) and 20 patients with FLE (mean age: 32.25 ±â€¯11.92 years) were enrolled in the study and their cognitive performance was compared with 20 healthy controls (mean age: 33.15 ±â€¯13.66 years). Neuropsychological tests were performed on the participants for sleep, depression, anxiety, impulsivity, intelligence, attention, language functions, memory and learning, and frontal axis functions. Decision-making performance in ambiguous situations was studied using the Iowa Gambling Task (IGT). RESULTS: Iowa Gambling Task performances of patients with FLE and TLE were found to be worse than in healthy controls (p = 0.049). Although there was no statistically significant difference when the decision-making of patients with TLE and FLE was compared, it was observed that patients with FLE chose higher risk cards compared with those with TLE. The performances of the neuropsychological subgroup tests of patients with TLE and FLE in attention, language functions, memory and learning, and frontal axis functions were found to be significantly worse than in healthy subjects. CONCLUSION: Decision-making in patients with TLE and FLE in ambiguous situations is similarly impaired compared with healthy controls.

Identifying relationships between kinesiophobia, functional level, mobility, and pain in older adults after surgery.

BACKGROUND: Further data on the causes of functional independence or disability after surgery are needed to explain the clinical decision-making process for older patients, their families, and policy-makers. There are a limited number of studies showing the relationship between kinesiophobia, functional status, pain and mobility in older adults after surgery. AIMS: The study aims to investigate relationships among kinesiophobia, pain, mobility, and functional status in older adults after surgery. METHODS: A comparative-descriptive and cross-sectional study. The research was conducted with 99 older adults in the general surgery clinic after surgery. A Visual Analogue Scale was used to evaluate pain levels, the Standardized Mini-Mental State Examination to evaluate mental function status, the Functional Independence Measure to assess functional independence in daily activities, the Rivermead Mobility Index to evaluate basic mobility in daily life, and the Tampa Scale for Kinesiophobia to assess fear of mobility. RESULTS: Regression analysis revealed a significant negative correlation between social security and kinesiophobia, and also between functional level and type of anesthesia and mental status in older women (R2 = - 0.185, p = 0.005; R2 = - 0.167, p = 0.011 and p = 0.005, respectively). DISCUSSION: In the literature, there are no standardized procedures during the evaluation and rehabilitation of older adults after abdominal or thoracic surgery, etc. operations. This study will contribute to the current literature by attracting interest in this field and increasing the evaluations performed. CONCLUSIONS: The study findings emphasize the importance of evaluating the functional, mobility, mental and kinesiophobic status of older adults after surgery in clinics, rehabilitation centers, or research.

The relationship between aerobic capacity and cognitive/academic performance in medical students.

The positive relationship between aerobic capacity and cognitive performance is well known, but there is little information regarding young adults. Therefore, we aimed to test the hypothesis that aerobic capacity (VO2max) correlates with cognitive and academic performance in medical students who have higher academic achievement with academic performance. We included 65 volunteer medical students who were in term 2/6 in this descriptive, cross-sectional study. Body composition and the International Physical Activity Questionnaire and cardiopulmonary exercise test results of all participants were analyzed. Lumosity application with 6 categories of cognitive tests was applied to evaluate cognitive performance. The university entrance exam scores of the students were taken into consideration to assess their academic performance. We observed a significant "positive" relationship between aerobic capacity and some domains of cognitive performance, especially problem solving (p < 0.05), but we did not find a significant relationship between aerobic capacity and academic performance. Consequently, although we confirmed the existence of a positive effect of high aerobic capacity on cognitive performance stated in the literature, we couldn't confirm this for all cognitive domains or academic performance. These results suggest that more comprehensive studies on this subject are needed.

Colistin resistance increases 28-day mortality in bloodstream infections due to carbapenem-resistant Klebsiella pneumoniae.

Mortality due to K. pneumoniae bacteremia is on rise, particularly in regions with high rates of carbapenem and colistin resistance. We aimed to define risk factors for colistin resistance and its impact on mortality. Patients diagnosed with "carbapenem-resistant K. pneumoniae (CRKp)" bacteremia between 2014 and 2018 were divided into two groups as "colistin susceptible (ColS)" and "colistin resistant (ColR)" based on broth microdilution method. Retrospective case-control study was conducted to compare characteristics and outcomes. Multiple logistic regression model was used to define independent risk factors for acquired colistin resistance and Cox proportional hazard model for 28-day mortality. A total of 82 patients (39 ColS and 43 ColR) were included. Mean age was 61.5 years, and 50 (61%) were male. Colistin resistance was significantly increased with duration of hospital stay (p = 0.007) and prior colistin use (p = 0.007). Overall, the 28-day mortality rate was 66%. Age (p = 0.014) and colistin resistance significantly increased 28-day (p = 0.009) mortality. Microbiological response to treatment within 7 days favors survival. PFGE analysis revealed an outbreak with K. pneumoniae ST78 and ST45 clones. Patients treated with combined antimicrobials had significantly lower 28-day mortality (p = 0.045) in comparison to monotherapy. However, types of combinations did not show significant superiority on each other. Colistin resistance increases 28-day mortality in CRKp bacteremia. Although combined regimens are more effective than monotherapy, existing antibacterial combinations have no apparent superiority to each other. New treatment options are pivotal.

Risk factors affecting seizure recurrence in childhood epilepsy during short-term follow-up.

PURPOSE: The aim of this study is to examine the factors affecting seizure recurrence in pediatric patients diagnosed with epilepsy. METHODS: Three hundred patients presenting to the pediatric neurology clinic between 2015 and 2018 and diagnosed with epilepsy and treated with single antiseizure drug were included in the study. Medical histories and clinical and laboratory findings were retrieved retrospectively from the hospital data system. The combined and adjusted effects of risk factors on seizure recurrence were evaluated using multivariate binary logistic regression analysis. RESULTS: Boys had a higher rate of seizure recurrence than girls. Seizure recurrence was also higher in patients with abnormal neurological examinations at the time of diagnosis compared to those with normal neurological examinations. Seizure recurrence was significantly higher in patients with global growth retardation. Epilepsy patients with abnormal MRI findings also had a higher rate of seizure recurrence than patients with normal neuroimaging findings. In addition, seizure recurrence was significantly higher in epilepsy patients with comorbidities such as cerebral palsy and autism spectrum disorders compared to patients without comorbidities. No significant association was observed between seizure recurrence and the first drug, perinatal asphyxia history, localization of epileptiform discharges on EEG, family history of epilepsy, family history of febrile seizures, history of stay in the neonatal intensive care unit during the perinatal period, or preterm delivery. CONCLUSION: Abnormal neurological examination, abnormal neuroimaging and accompanying comorbidities, and global growth retardation at the time of diagnosis are important factors affecting seizure recurrence in pediatric patients with epilepsy.

Bartonella henselae IgM seropositivity in both adult and pediatric patients with diverse clinical conditions in Turkey.

Bartonella henselae is the causative agent of cat scratch disease (CSD). In this study, we aimed to investigate the clinical data of patients with suspicion of CSD and delineate current epidemiological features.A total of 785 patients with suspected CSD were included in the study. B. henselae IgM antibody was determined by indirect fluorescent antibody (IFA) test using a commercial kit (Euroimmun, Germany). Sex, age, clinical pre-diagnosis and animal contact information of the patients were obtained from hospital electronic database records.Seventy-eight (9.9%) of 785 samples were seropositive. Out of 78 patients, 46 with animal contact data were further analyzed. Of these patients, 56% were male, and 41% were under 18 years of age. Seropositivity was more commonly observed in fall and winter. The most common finding was lymphadenitis (63%). Thirty-five patients (76%) had a previous history of animal contact (cat/dog). Of the 46 seropositive patients, 78.3, 15.2, 4.4, and 2.1% had titers of 1:80, 1:160, 1:320, and 1:640, respectively.Our study confirms that CSD is not rare in Turkey. Thus, it should always be considered in the differential diagnosis of patients presenting with lymphadenopathy in all age groups, particularly children. Questioning of cat exposure should never be neglected, especially in areas with intense population of stray cats, such as Istanbul.

The effect of 75-g oral glucose tolerance test on maternal and foetal Doppler parameters in healthy pregnancies: a cross-sectional observational study.

Hyperglycaemia can alter placental resistance to blood flow and hyperglycaemia has adverse perinatal outcomes. Oral glucose tolerance testing (OGTT) increases the maternal plasma glucose levels temporarily and mimics metabolic hyperglycaemia. The blood flow of the uterine artery (UtA), umbilical artery (UA), middle cerebral artery (MCA) were assessed before, 1 and 2 h following the OGTT by using Doppler ultrasonography. Z-score of cerebroplacental ratio (CPR), pulsatility index (PI) for three vessels were evaluated separately. All measurements of the MCA, UA, UtA Doppler parameters were not statistically different for fasting, and 1 and 2 h following the 75 g OGTT in the 53 pregnant women with a singleton gestation in the low-risk group. This study results show that acute hyperglycaemia induced by OGTT has no effect on maternal and foetal Doppler parameters in healthy pregnancies.IMPACT STATEMENTWhat is already known on this subject? Foetal glucose is affected by maternal blood glucose concentrations and placental blood flow. Acute hyperglycaemia may have an effect on maternal, and foetal Doppler parameters among healthy pregnanciesWhat do the results of this study add? Our findings indicate that blood flow velocity metric measurements in the UA, MCA and UtA were not affected by the OGTT in healthy pregnant women.What are the implications of these findings for clinical practice and/or further research? Acute hyperglycaemia induced by OGTT does not have any effect on fetomaternal circulation, especially foetal brain blood flow. Other foetal vessels including ductus venosus, renal artery, etc. may be affected by maternal blood glucose levels during the OGTT or in diabetic patients. Future prospective studies consisting of diabetic patients are warranted to verify the exact effect of glucose levels on foetal and maternal circulation.

Determining the cut-off values of tumor diameter, degree of extraprostatic extension, and extent of surgical margin positivity with regard to biochemical recurrence of prostate cancer after radical prostatectomy.

BACKGROUND: The pre-biopsy (bx) prostate-specific antigen (PSA) level, tumor volume/diameter, degree of extraprostatic extension (EPE), and extent of surgical margin positivity have been shown to be significant prognostic parameters of biochemical recurrence (BCR) after radical prostatectomy. The present study assessed the cut-off values of the pre-bx PSA level, maximum tumor diameter, radial and circumferential distances of EPE, and circumferential length of surgical margin (SM) positivity with regard to BCR. MATERIAL AND METHODS: The study included 445 radical prostatectomy specimens, and the cut-off values of all parameters were determined using receiver operating characteristic curve analysis. RESULTS: An ISUP grade group ≥ 3, radial distance of EPE >1 mm, and circumferential length of SM positivity ≥2 mm were identified as independent predictors of BCR after radical prostatectomy. The parameters that showed statistical significance in univariate analysis, such as pre-bx PSA level ≥ 7.20 ng/mL, tumor diameter ≥ 19.5 mm, presence of seminal vesicle invasion, and circumferential distance of EPE >3 mm, did not have independent prognostic values for BCR. CONCLUSIONS: An ISUP grade group ≥ 3, radial distance of EPE >1 mm, and circumferential length of SM positivity ≥2 mm are predictors of BCR. Our findings might have significance in risk classification and adjuvant therapy consideration among patients with localized prostate cancer.

Reliability and validity of Turkish version of pregnancy physical activity questionnaire (PPAQ) in patients with gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) is a common complication during pregnancy. Evaluation of the quantitative physical activity in diabetic pregnant women is critical. The aim of this study was to test the reliability and validity of the Pregnancy Physical Activity Questionnaire (PPAQ) in Turkish patients with GDM. A total of 120 pregnant women between the ages of 18 and 44 years with GDM were included. The reliability of the questionnaire was measured by internal consistency and analysis of 2-week test-retest reliability. Of the patients, 74 completed the test-retest procedure. Concurrent validity was examined by comparing the PPAQ with the Short Form of the International Physical Activity Questionnaire (IPAQ) in 36 patients. Test-retest intraclass correlation coefficient scores varied between 0.72 and 0.95. The Spearman rank correlation analysis showed that the PPAQ total activity values were statistically significantly correlated with the total values of IPAQ-Short Form (r = 0.410 and p = .030). In conclusion, the Turkish version of the PPAQ is a valid and reliable tool for the measurement of the physical activity level of pregnant women with GDM.Impact statementWhat is already known on this subject? The pregnancy physical activity questionnaire (PPAQ) developed in 2004 by Chasan-Taber et al.; is a simple and short questionnaire measuring the frequency, duration, and intensity of physical activity in pregnant women. To date, this questionnaire has been translated into many languages and has been used in a number of studies.What do the results of this study add? The aim of this study was to test the reliability and validity of the PPAQ in Turkish pregnant women with GDM. On the basis of our study results, we suggest that the Turkish version of the PPAQ is a valid and reliable tool for the measurement of the physical activity level of pregnant women with GDM.What are the implications of these findings for clinical practice and/or further research? Evaluation of the quantitative physical activity in diabetic pregnant women may contribute to gain a better understanding of the role of physical activity during treatment and may be useful to compare the results of different studies carried out in different places more effectively.

A New Method for Determining the Level of the Carotid Artery Bifurcation.

Exact localization of the bifurcation of the common carotid artery using skin surface landmarks is important for various diagnostic and therapeutic purposes, including emergency cases. Traditional methods have confirmed their accuracy in only a certain percentage of cases and there are inconsistencies among various publications. The cervical computed tomography-angiographic examinations for any diagnostic purpose between June 2017 and December, 2017 in the authors' hospital were examined. Measurements were performed for (MT-CB) and (MT-SE) distances and the results were recorded [MT = The tip of the mastoid process; CB = common carotid artery bifurcation; SE = sternal extremity of the clavicle]. Cervical computed tomography angiography was found in the records of 91 patients in the 6-month period between June 2017 and December 2017. After exclusion criteria were applied, a total of 116 carotid bifurcation levels on the right and left sides were measured in 58 patients. The mean MT-CB distance was 6.29 ±â€Š0.9 cm (range: 2.9-8.4 cm). The mean distance between MT and SE was 15.3 ±â€Š1.7 cm (range: 9.9-19.0 cm). The (MT-CB): (MT-SE) ratios ranged from 29% to 51% with a mean of 41 ±â€Š4.2% (95% CI: 39.88%-42.10%) and a median of 41.1% (P < 0.05) (Kolmogorov-Smirnov test). The distance ratio values did not change significantly according to age and gender (respectively P = 0.341, P = 0.093). These results show that the CB is usually located at two-fifths of the distance from the mastoid tip to the sternal extremity of the clavicle and closer to the mastoid tip.

Investigation of plasmid mediated AmpC beta-lactamases in Escherichia coli and Klebsiella pneumoniae isolates by phenotypic and genotypic.

OBJECTIVE: To investigate the susceptibility and specificity of the phenotypic methods to determine plasmidmediated AmpC. METHODS: The cross-sectional study was conducted at Duzce University Faculty of Medicine, Microbiology Laboratory from January 2015 to June 2016, and comprised Escherichia coli and Klebsiella pneumonia isolates intermediate susceptible or resistant to cefoxitine. Combined disk diffusion test, double disc synergy test, agar gradient test and polymerase chain reaction were used to detect plasmid-mediated AmpC. RESULTS: Of the 2024 E. coli samples, 44(2.17%), and of the 792 K. pneumoniae samples, 16(2%) were included. Combined disk diffusion test had susceptibility of 68% and specificity of 50%; double disc synergy test 24% and 82%; and agar gradient test 40% and 68%. Of the isolates positively detected by polymerase chain reaction method, more than one gene region positivity was detected in 15(25%) isolates. CONCLUSION: All three phenotypic methods were found to be insufficient to detect plasmid-mediated AmpC positivity.

Seroprevalence of hantavirus and Borrelia burgdorferi in Düzce (Turkey) forest villages and the relationship with sociodemographic features

Background/aim: Hantavirus and Borrelia burgdorferi are two zoonotic agents that pose a great risk especially for people living in forest areas. This study aimed to investigate the seroprevalence of hantavirus and B. burgdorferi in forest villages of Düzce and its relationship with sociodemographic features. Materials and methods: The presence of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against hantavirus and B. burgdorferi in serum samples was investigated via enzyme-linked immunosorbent assay (ELISA). Hantavirus IgG and B. burgdorferi IgM and IgG positivity was then validated by western blot (WB) method. Results: During the analyses, 193 serum samples were tested. Eleven (6%) cases of hantavirus IgM was found positive by ELISA. Six (3%) cases of hantavirus IgG, 3 (2%) cases of B. burgdorferi IgM, and 12 (6%) cases of B. burgdorferi IgG were found positive by WB. Borrelia burgdorferi IgG positivity was found to be higher in the 46­70 age group and it was seen that the positivity was the highest among those who lived in mud-brick houses. Conclusion: This study was the first to determine the frequency of hantavirus in the study region and it includes current data for B. burgdorferi. Consequently, it is recommended that similar studies be carried out on rodents in all the regions at risk.

Evaluation of the effects of different forms of periodontal diseases on quality of life with OHIP-14 and SF-36 questionnaires: A cross-sectional study.

OBJECTIVES: To investigate the effect of generalized aggressive periodontitis (GAP), generalized chronic periodontitis (GCP) and gingivitis (G) on oral health-related quality of life (OHRQoL) with Oral Health Impact Profile-14 (OHIP-14) and Short Form-36 (SF-36) questionnaires. METHODS: One hundred GAP patients, 114 GCP and 109 G patients were included in the study. Age, gender, number of missing teeth, probing depth (PD), bleeding on probing (BOP), plaque index (PI) and clinical attachment level (CAL) of patients were recorded. The Turkish versions of OHIP-14 and SF-36 questionnaires were filled before any medication and dental treatment were approved. The one-way ANOVA test was used to compare three groups. RESULTS: Generalized aggressive periodontitis and GCP groups were similar to each other (P > 0.05) in most subscales except functional limitation and social disability of the OHIP-14 questionnaire (P = 0.034 and P = 0.018, respectively); conversely, there was no statistically difference between GAP and G groups in functional limitation and social disability subscales (P = 0.856 and P = 0.242, respectively). GAP group gave higher scores than GCP group in all subscales of SF-36 (P < 0.05). There was a negative correlation between OHIP-14 and SF-36 subscale scores in all groups. CONCLUSION: Study findings indicate that different forms of periodontal disease have different effects on quality of life of patients when measured by OHIP-14 and SF-36. Patients with GCP and GAP had poorer OHRQoL than G patients.