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.

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.

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.

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.

[Investigation of congenital CMV infection with the presence of CMV DNA in saliva samples of new born babies]. / Yenidogan bebeklerin tükürük örneginde CMV DNA varligi ile konjenital CMV enfeksiyonunun arastirilmasi.

Cytomegalovirus (CMV), is the most common cause among congenital infections and is the most seen etiology in long-term sensorineural hearing loss (SNHL) and neurological impairment. Congenital CMV infection (CCMV) was reported in 0.15-2.2% of live-borne neonates in studies from different countries. A significant proportion of infected infants are asymptomatic after birth and might only be detected by routine screening methods during the new born period. The aim of this study was to screen the saliva of live-born neonates with areal-time PCR based method for the detection of CCMV in our hospital. Saliva samples collected in half an hour after birth by dry dacron swabs and were evaluated for CMV DNA (Rt-PCR, Abbott Molecular USA) from 1000 babies born in Ege University Faculty of Medicine Hospital Obstetrics Clinic between October 2015-October 2017. For the confirmation of CCMV, saliva positive newborns were evaluated with the same method for CMV DNA from their urine or blood within 21 days. All newborns were screened for sensorineural hearing tests. Subjects were 497 girls (49.7%) and 503 boys (50.3%), with a mean weight of 3116.8 g and mean of 37.61 birth week. CMV DNA was positive in the saliva of 16 newborns (1.6%). Fourteen newborns were weakly positive for CMV DNA in their saliva and were not confirmed for CCMV infection. Congenital CMV was confirmed in only two (0.2%) with the CMV DNA results in urine and/or blood samples. One of the two newborns with CCMV was symptomatic and had a neurosensorial hearing loss. The other one was asymptomatic. Saliva samples, taken immediately after birth with a noninvasive and easy method for the detection of CMV DNA is very important for diagnosis of CCMV. Positive samples should be confirmed with CMV DNA in urine or blood samples of these newborns. In this study, detection of positivity in saliva samples that were confirmed with other samples of our newborn population for CCMV was 0.2%. The specific diagnosis for CCMV in newborns with a noninvasive and easy collecting sample is important to avoid sequelae and for public health concerns.

Posterior reversible encephalopathy syndrome in IgA vasculitis: Neuroimaging of a 14-year-old child.

IgA vasculitis (IgAV) is a leukocytoclastic vasculitis and characterized by involvement of small vessels in skin, gastrointestinal system, joints, kidneys, and less frequently other organs. It is the commonest vasculitis in childhood and etiology is not completely known. Neurological manifestations of IgAV are very rare and usually seen in patients with severe hypertension or as an uncommon feature such as peripheral neuropathy. Posterior reversible encephalopathy syndrome (PRES) is a clinic-radiologic entity characterized with temporary vasogenic edema developing typically in posterior circulation of the brain and has been reported as a rare manifestation of IgAV. In this paper, a PRES case of 14-year-old male with IgAV is reported and etiopathogenesis was discussed with literature. Diagnosis was made by magnetic resonance imaging because of the existence of neurological symptoms (headache and visual loss) during the course of disease. His radiological findings have resolved with therapy. Although neurological involvement is a rare manifestation in IgAV, we recommend magnetic resonance imaging in such patients for diagnosis and evaluation of complications.

Morus Rubra Extract Induces Cell Cycle Arrest and Apoptosis in Human Colon Cancer Cells Through Endoplasmic Reticulum Stress and Telomerase.

Many studies have reported cytotoxic effects of different Morus species, but there have been only limited studies on the cytotoxic effect of Morus rubra. The aims of this study were to evaluate the cytotoxic effect of dimethyl sulfoxide extract of M. rubra and to investigate, for the first time, its probable cytotoxic activity in human colon cancer (WiDr) cells, together with the mechanism involved. The cytotoxic activity of extract was determined using MTT assay. The mechanism involved in the cytotoxic effect of extract was then evaluated in terms of apoptosis, and the cell cycle using flow cytometry, mitochondrial membrane potential (MMP) was investigated using the fluorometric method, and expression levels of telomerase and C/EBP homologous protein (CHOP) were investigated using reverse-transcription PCR (RT-PCR). M. rubra extract exhibited moderate selective cytotoxicity on colon cancer cells compared with fibroblast cells. Extract induced cell cycle arrest at the G1 phase and apoptosis via reduced MMP in WiDr cells. Additionally, M. rubra extract significantly repressed telomerase and induced CHOP expressions in WiDr cells. Our results demonstrate that targeting telomerase and endoplasmic reticulum stress represents a promising strategy in colon cancer therapy, and M. rubra may have considerable potential for development as a novel natural product-based anticancer agent.

Serum prolidase activity, oxidative stress, and antioxidant enzyme levels in patients with renal cell carcinoma.

OBJECTIVES: Prolidase is a member of the matrix metalloproteinase family. It plays a vital role in collagen turnover, matrix remodeling, and cell growth. Reactive oxygen species (ROS) have been implicated in the pathogenesis of various diseases, including cancers. Oxidative stress can cause tumor angiogenesis and may be carcinogenic. However, the relationship between antioxidant capacity and various cancers has been researched in several clinical trials. In our study, we aimed to identify serum prolidase activity, oxidative stress, and antioxidant enzyme levels in patients with renal tumors and to evaluate their relationships with each other. MATERIALS AND METHODS: A total of 37 male patients with renal cell cancer and with a mean age of 56.28 ± 3.1 were included in the study. The control group comprising 36 male patients (mean age 56.31 ± 2.9) was randomly selected among the volunteers. Serum samples for measurement of superoxide dismutase (SOD), glutathione peroxidase (GSHPx), glutathione-S-transferase (GST), malondialdehyde (MDA), glutathione (GSH), and prolidase levels were kept at -20°C until they were used. RESULTS: Serum prolidase activity and MDA levels were significantly higher in renal cancer patients than in controls (all, p < 0.05), while SOD, GSHPx, and GST levels were significantly lower (p < 0.05). CONCLUSION: Our results indicate that increased prolidase seems to be related to increased oxidative stress along with decreased antioxidant levels in renal cancer.

The relationship between serum paraoxonase levels and carotid atherosclerotic plaque formation in Alzheimer's patients.

Low paraoxonase 1 (PON1) activity and carotid atherosclerosis have been suggested to be important risk factors for dementia. However, the studies to date could not fully clarify the relationship between PON1, carotid atherosclerosis and dementia. The present study aimed to measure carotid atherosclerosis and PON1 activity in Alzheimer's Disease and to evaluate the relationship between them. The study included 25 Alzheimer's patients and 25 control subjects, for a total of 50 individuals. The study measured the serum PON1 activity and other biochemical parameters and carotid atherosclerotic plaque values of the participants. The mean paraoxonase activity (31.06±2.31U/L) was significantly lower in the Alzheimer's group compared to the control group (59.05±7.05U/L) (P<0.001). Nonetheless, the carotid plaque values were significantly higher in the patient group (3.02±0.52mm) compared to the control group (1.84±0.45mm) (P<0.001). Furthermore, there was a negative correlation (81.0%) between PON1 activity and carotid plaque in the overall study group (P<0.05). Also serum homocystein level was higher in the patient group (22.15±7.05) compared to the control group (13.30±3.32). In conclusion, our findings show inverse association between PON1 activity and carotid atherosclerosis in Alzheimer patients: the lower the PON1 activity the more progressed the atherosclerotic process in AD.

Evaluation of 28 cases of mucormycosis.

Mucormycosis is a rare but invasive fungal disease with high mortality. The present study aimed to retrospectively investigate the demographic characteristics, as well as the clinical, radiological and laboratory features and the results of treatment, in the patients followed in our hospital because of mucormycosis. The present study retrospectively evaluated 28 cases, which were followed in our hospital because of mucormycosis between January 2002 and July 2013. The clinical form was rhinocerebral in 27 cases (rhinoorbital in 12, nasal in 8 and rhinoorbitocerebral in 7) and disseminated in one case. With regard to predisposing factors, diabetes mellitus (n = 20), haematological malignancy (n = 6) and chronic renal insufficiency (n = 5) were the leading concomitant diseases. Seventeen (61%) of 28 cases showed atypical clinical picture. With regard to the therapeutic outcomes; it was found that 14 (50%) cases died and six cases recovered with sequel. Today, when particularly the prevalence of immunosuppressive diseases and conditions are gradually increasing, the incidence of mucormycosis is also increased. Considering that the majority of our cases had atypical clinical involvement and complications, being familiar with the characteristics of this disease could be life-saving together with early diagnosis and treatment.

Smoking-related Alterations in Serum Levels of Thyroid Hormones and Insulin in Female and Male Students.

CONTEXT: Cigarette smoking has large-scale and complex effects on the endocrine system. Various studies related to cigarette smoking have provided differing results. Therefore, more research is needed to determine the effects on the body that are created by cigarette smoking. OBJECTIVES: The study was designed to investigate the effects of cigarette smoking, primarily on thyroid hormones in serum, such as on levels of total triiodothyronine (tT3), free triiodothyronine (fT3), total thyroxine (tT4), free thyroxine (fT4), thyroid-stimulating hormone (TSH) (ie, thyrotropin), and insulin of young students aged 18-25 y. DESIGN: This study was a randomized, controlled trial. SETTING: The study was performed in the Department of Physiology, School of Medicine, Yuzuncu Yil University (Van, Turkey). PARTICIPANTS: Eighty healthy students, 40 females and 40 males, were included in the study. INTERVENTION: Of the 40 female participants, 25 were smokers, and 15 were nonsmokers. Of the 40 male participants, 25 were smokers, and 15 were nonsmokers. The intervention (smoking) group, therefore, consisted of 50 participants, and the control (nonsmoking) group consisted of 30 participants. OUTCOME MEASURES: Serum concentrations of thyroid hormones and insulin were determined by enzyme-linked immunesorbent assays (ELISAs), using monoclonal antibodies; and by measurement of blood glucose, using a glucometer. RESULTS: The study found that both female and male smokers had higher levels of serum tT3 and insulin hormone than nonsmokers had. A positive correlation was found between age and insulin resistance in male smokers. The study also found that male smokers had higher levels of serum tT3 and fT4 hormone than female smokers had. CONCLUSIONS: Smoking may be associated with an increased secretion of thyroid hormones and the development of insulin resistance. With aging, insulin resistance may increase more in male smokers than in female smokers.

[Prevalence and seasonal distribution of respiratory viruses in patients with acute respiratory tract infections, 2002-2014]. / Akut solunum yolu enfeksiyonu olan hastalarda solunum viruslarinin prevalansi ve mevsimsel dagilimi, 2002-2014.

The aim of this study was to investigate the prevalence and seasonal distribution of respiratory viruses in pediatric and adult outpatients and inpatients who were admitted to hospital with the symptoms of upper and lower respiratory tract infections, during a 12-year period. A total of 5102 clinical samples (4372 nasopharyngeal swabs, 316 bronchoalveolar lavages, 219 transtracheal aspirates, 163 nasopharyngeal aspirates, 20 sputum, 10 nasal swabs) examined in our laboratory between January 1st 2002 and July 17th 2014, were evaluated retrospectively. Of the specimens, 1107 (21.7%) were obtained from outpatients and 3995 (78.3%) from hospitalized patients. Of the patients, 2851 (55.9%) were male and 2251 (44.1%) were female, while 1233 (24.2%) were adults and 3869 (75.8%) were children (age range: 1 day - 93 years; median: 3 years). Respiratory samples were investigated for the presence of respiratory syncytial virus (RSV), influenza virus type A and B (INF-A, INF-B), adenovirus (AdV), parainfluenza viruses (PIV types 1-4), human rhinoviruses (HRV), human coronaviruses (HCoV), human metapneumovirus (HMPV) and human bocavirus (HBoV). All specimens were tested by both direct immunofluorescence antibody (DFA) and shell vial cell culture (SVCC) methods. In DFA assay the samples were initially screened by fluorescent-labeled polyclonal antibodies, and the positive ones were typed by using monoclonal antibodies (Light Diagnostics, Merck Millipore, USA). In SVCC, HEp-2, MDCK, A-549 and Vero cell lines were used for the isolation of viruses. In addition to these methods, real-time multiplex PCR methods (RealAccurate®, Respiratory RT PCR, PathoFinder, Netherlands and Seeplex® RV15 ACE Detection, Seegene, South Korea) were used for the detection of respiratory viruses in samples (n= 2104) obtained from 2007 to 2014. Respiratory viruses were detected in a total of 1705 (33.4%) patients, of them 967 (19%) were male and 738 (14.4%) were female. Three hundred and eighteen (18.6%) of the 1705 patients were infected with multiple respiratory viruses. The most frequently observed co-infections were RSV+INF-A (40/318; 12.6%), and RSV+PIV (33/318; 10.4%). The rate of positivity for the respiratory viruses in pediatric and adult groups were 35.4% (1369/3869) and 27.3% (336/1233), respectively (p< 0.000). The most frequently detected virus in pediatric group was RSV (336/1369; 24.5%), followed by influenza viruses (314/1369; 22.9%), PIV (197/1369; 14.4%), HRV (118/1369; 8.6%), AdV (75/1369; 5.5%) and the others (49/1369; 3.6%). On the other hand the most frequently detected virus in adult group was influenza viruses (181/336; 53.8%) followed by AdV (37/336; 11%), RSV (24/336; 7.1%), PIV (24/336; 7.1%), HRV (23/336; 6.8%) and the others (9/336; 2.7%). The rate of multiple virus infections in pediatric and adult groups were 7.2% (280/3869) and 3% (38/1233), respectively. Most of the coinfections (280/318; 88%) were detected in children. Respiratory viruses were detected positive in 40.2% (445/1107) of outpatients, and in 31.5% (1260/3995) of inpatients (p< 0.000). The most frequent viruses detected in pediatric outpatients and inpatients were HRV and RSV, respectively, while influenza viruses were the first in line among both adult outpatients and inpatients. During the study period, a PIV-3 outbreak (n= 96) have emerged between December 2004-April 2005, and an influenza A (H1N1)pdm09 outbreak (n= 207) between November 2009-January 2010. When the seasonal distribution was considered, the isolation rates of 1705 respiratory viruses in winter, spring, summer and autumn were 44.4%, 27%, 8.3% and 20.3%, respectively. RSV was most frequently detected from December to March, influenza viruses from November to March, HRV from December to June, and mixed infections from January to February. In conclusion, the data of our study obtained in about 12-year period indicated that the prevalence of respiratory viruses in acute respiratory infections is 33.4%, and they typically active during the months of winter and early spring in our region.

Assessment of adenosine deaminase (ADA) activity and oxidative stress in patients with chronic tonsillitis.

To emphasize the effectiveness of adenosine deaminase (ADA) enzyme, which has important roles in the differentiation of lymphoid cells, and oxidative stress in patients with chronic tonsillitis. Serum and tissue samples were obtained from 25 patients who underwent tonsillectomy due to recurrent episodes of acute tonsillitis. In the control group, which also had 25 subjects, only serum samples were taken as obtaining tissue samples would not have been ethically appropriate. ADA enzyme activity, catalase (CAT), carbonic anhydrase (CA), nitric oxide (NO) and malondialdehyde (MDA) were measured in the serum and tissue samples of patients and control group subjects. The serum values of both groups were compared. In addition, the tissue and serum values of patients were compared. Serum ADA activity and the oxidant enzymes MDA and NO values of the patient group were significantly higher than those of the control group (p < 0.001), the antioxidant enzymes CA and CAT values of the patient group were significantly lower than those of the control group (p < 0.001). In addition, while CA, CAT and NO enzyme levels were found to be significantly higher in the tonsil tissue of the patient group when compared to serum levels (p < 0.05), there was no difference between tissue and serum MDA and ADA activity (p > 0.05). Elevated ADA activity may be effective in the pathogenesis of chronic tonsillitis both by impairing tissue structure and contributing to SOR formation.

Radionuclide imaging for breast cancer diagnosis and management: is technetium-99m tetrofosmin uptake related to the grade of malignancy?

There are different scoring systems available for determining the grade of breast cancer malignancy. Breast cancer tumors have been described for grades 1-3 using the modified Nottingham-Bloom-Richardson grading system. Determining the grade is very important for the clinicians to choose the best treatment options. Technetium-99m methoxy isobutyl isonitrile ((99m)Tc-MIBI) and pentavalent (99m)Tc-dimercaptosuccinic acid ((99m)Tc(V)-DMSA) scintigraphy have been used and are under evaluation for being prognostic factors for breast carcinoma. Radionuclide breast imaging not only visualizes the lesion site but also reflects specific biological and functional lesion features, including perfusion, proliferative potential, metabolic activity and receptor status.

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.

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.

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.

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.