In Vitro Evaluation of Color and Surface Roughness Changes of Polyetheretherketone, Monolithic Zirconia, and Resin Nanoceramics Exposed to Staining Liquids.

BACKGROUND: This study aims to investigate color stability and surface roughness of polyetheretherketone (PEEK), zirconia, and hybrid ceramics while stored in different liquids. METHODS: A total of 240 specimens were prepared from monolithic zirconia, PEEK, and hybrid ceramics. All specimens were polished using rubber sets with different grain sizes. Color parameters (L*, a*, b*) were measured three times using a dental spectrophotometer in standard D65 lightning. Each group was divided into eight different groups to be kept in eight different solutions as distilled water, cola, red wine, tea, coffee, heptane, citric acid, and 50% ethanol. Specimens were held in solutions at 37°C for 12 days. Color measurements were repeated, and color change (ΔE) was calculated using the CIE Lab formula. RESULTS: The color difference of PEEK specimens was found above the clinically acceptable limit; however, color differences for monolithic zirconia produced by coffee were found within the clinically acceptable limits. ZR and HC specimens' color change values were found between threshold values (1<ΔE < 3.3). The differences observed in surface roughness levels amongst the ZR specimens could be caused by the polishing instrument and procedure. CONCLUSION: The color change of the materials was within acceptable limits, whereas the surface roughness increased more than 0.2 µm. Especially cola, heptane, and red wine significantly increased the mean surface roughness.

EMPTY SELLA IN A PATIENT WITH CLINICAL AND BIOCHEMICAL DIAGNOSIS OF ACROMEGALY.

Background: Acromegaly is an acquired disorder related to excessive production of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Empty sella (ES) is an anatomical condition of sella turcica that is partially or completely filled with cerebrospinal fluid mainly due to intrasellar herniation of subarachnoid space. Here, we describe a patient who presented with clinical and biochemical features of acromegaly and who had an ES on pituitary magnetic resonance imaging (MRI). Case report: A 73-year-old male patient was consulted in our clinic because of the acromegalic phenotype while planning for colorectal adenocarcinoma surgery. The patient noticed gradual enlarging of his hands, feet and nose for 30 years, but never consulted to any clinician for this reason. Serum GH was 20.6 ng/mL (normal <3 ng/mL) and IGF-1 was 531 ng/mL (normal, 69-200 ng/ml). An oral glucose tolerance test showed no suppression of GH values. T1-weighted MRI revealed an ES. 18F-FDG PET/CT and Ga-DOTATADE PET/CT did not show any finding consistent with ectopic GH secretion. Growth hormone releasing hormone (GHRH) was within the normal range (<100mg/dL). He was treated with long-acting octreotide 20 mg per 28 days. At the 6th month of treatment, serum GH and IGF-1 levels were decreased to 5.45 ng/mL and 274 ng/mL, respectively. Conclusion: The mechanism underlying the association of acromegaly and ES remains unclear. Apoplexy on existing pituitary adenoma and then formation of necrosis can proceed to ES. Since our patient did not have a history of pituitary apoplexy and we could not find any reason for secondary ES, we considered primary ES.

The association between preoperative 25-OH vitamin D levels and postoperative complications in patients undergoing colorectal cancer surgery.

BACKGROUND: Determining the modifiable risk factors for postoperative complications is particularly significant in patients undergoing colorectal surgery since those are associated with worse long-term outcomes. METHODS: Consecutive newly diagnosed 104 colorectal cancer patients were prospectively included in this single-center observational study. Preoperative serum 25-OH vitamin D levels were measured and analyzed for infectious and postoperative complications. RESULTS: Serum 25-OH vitamin D levels were found to be < 20 ng/ml in 74 patients (71.2%) and ≥ 20 ng/ml in 30 patients (28.8%); and the mean serum 25-OH vitamin D level was 15.95 (± 9.08) ng/ml. In patients with surgical site infection and infectious complications, 25-OH vitamin D levels were significantly lower than patients without complications (p = 0.036 and p = 0.026). However, no significant difference was demonstrated in 25-OH vitamin D levels according to overall postoperative complications. CONCLUSIONS: Our results suggest that vitamin D levels might be a potential risk factor for infectious complications in patients undergoing colorectal cancer surgery.

The distribution of geriatric problems in otolaryngology and their alteration from young adults.

BACKGROUND: Many changes occur in human physiology with aging, and as expected complaints of geriatric patients differ from the other age groups in population. AIMS: The objective of the study was to investigate the common complaints of geriatric patients attending to an otolaryngology clinic (ENT clinic), and to compare their complaints with the 18-65 years aged patients'. Materials and. METHODS: A total number of 41888 adult patients who visited the ENT clinic from 2015 to 2018 were retrospectively investigated. Patient complaints were scanned, and subcategorized as five groups (otologic/rhinologic/head and neck/ others/ neoplasias) and all data were evaluated. RESULTS: Forty-one thousand, eight hundred and eighty-eight patients were included in the study, and 3946 of them were geriatric patients. The most frequent problem was otologic problems, followed by rhinologic problems among geriatric patients. However, rhinologic problems were the major complaint among the 18-65-year-old patients. A comparison of all the individual complaints bringing the geriatric patients to the ENT clinic revealed the three most frequent complaints: 1. hearing loss, 2. balance disorders, and 3. common cold. However, the three major complaints beyond nongeriatric adults were 1. tonsillopharyngeal disease, 2. common cold, and 3. inflammatory and infectious diseases of the sinuses, and these differences were statistically significant (P = 0.001*). CONCLUSION: It was found in this study that the five most frequently reported complaints of geriatric patients when applying to an ENT clinic are hearing loss, loss of balance, common cold, cerumen, and tonsillopharyngeal diseases. Unlike from nongeriatric population, otologic problems (most commonly hearing loss) were the essential ENT clinic complaints of geriatric patients.

Primary Langerhans Cell Histiocytosis in Thyroid.

BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare group of neoplastic diseases resulting from Langerhans dendritic cells. The most common site (80%) is bones. Thyroid gland involvement is exceedingly rare and usually expected to be seen as a part of multisystemic disease. CASE REPORT: We present a 45 year old male patient operated due to multinodular goiter and neck pain, and diagnosed with LCH in his postoperative pathologic examination. As a result of the systemic screening performed after the pathological diagnosis, the disease was interestingly localized to the thyroid gland. Systemic involvement did not develop in the two-year follow-up of the patient who did not receive additional chemotherapy treatment. CONCLUSION: It is difficult to diagnose LCH in the thyroid gland before surgery. Although surgical treatment with or without chemotherapy is recommended, surgery is not recommended alone since it is generally systemic involvement. However, in primary thyroid LCH cases limited to the thyroid gland, we recommend that only total thyroidectomy treatment should be kept in mind.

The effects of melatonin on oxidative stress and prevention of primordial follicle loss via activation of mTOR pathway in the rat ovary.

Mammalian Target of Rapamycin (mTOR) signaling pathway has important roles in the regulation of puberty onset, gonadotropin secretion, follicular development and ovulation. Melatonin (N-acetyl-5-methoxytryptamine) is a lipophilic hormone has multiple functions in regulating the fertility. Recent studies have shown that melatonin affected the number or maturation of follicles in the ovary. The aim of this study was to investigate the effects of melatonin on mTOR expression and quantity of follicle in rat ovary. In the present study, a total of 45 female rats were randomly divided into three groups. Group 1; Control (C), Group 2: Vehicle (V) and Group 3; Melatonin (M). Melatonin was administered intraperitoneally at a dose of 50 mg/kg/day for 30 days in Melatonin group. The effects of Melatonin on the expression of mTOR and downstream components  were determined by Western Blot and Reverse Transcriptase PCR analysis. Upon Western Blot and RT-PCR evaluations, we detected higher expression and activation of mTOR, P70S6K, PKCalpha, PCNA and higher numbers of primordial  follicles in melatonin group compared with V and C group. In addition to this results, melatonin decreased oxidative stress markers, such as MDA, on the contrary, levels of antioxidative markers, such as CAT and GPx, were increased by melatonin in rat ovary. This study indicated that melatonin may have a significant protective effect on primordial follicles and increase the expression of mTOR and downstream components in rat ovary. Melatonin treatment may have a beneficial effect on fertility.

Caloric restriction in lean and obese strains of laboratory rat: effects on body composition, metabolism, growth and overall health.

NEW FINDINGS: What is the central question of this study? How do lean and obese rats respond physiologically to caloric restriction? What is the main finding and its importance? Obese rats show marked benefits compared with lean animals. Reduced body fat is associated with improved longevity with caloric restriction (CR) in rodents. Little is known regarding effects of CR in genetically lean versus obese strains. Long-Evans (LE) and Brown Norway (BN) rats make an ideal comparison for a CR study because the percentage body fat of young adult LE rats is double that of BN rats. Male LE and BN rats were either fed ad libitum (AL) or were calorically restricted to 80 or 90% of their AL weight. The percentages of fat, lean and fluid mass were measured non-invasively at 2- to 4-week intervals. Metabolic rate and respiratory quotient were measured after 3, 6, 9 and 12 months of CR. Overall health was scored monthly. The percentage of fat of the LE strain decreased with CR, whereas the percentage of fat of the BN strain remained above the AL group for several months. The percentage of lean mass increased above the AL for both strains subjected to CR. The percentage of fluid was unaffected by CR. The average metabolic rate over 22 h of the BN rats subjected to CR was reduced, whereas that of LE rats was increased slightly above the AL group. The respiratory quotient of BN rats was decreased with CR. Overall health of the CR LE group was significantly improved compared with that of the AL group, whereas health of the CR BN rats was impaired compared with the AL group. Overall, the lean BN and obese LE strains differ markedly in fat utilization and metabolic response to prolonged CR. There appears to be little benefit of CR in the lean strain.

The place of D-dimer and L-lactate levels in the early diagnosis of acute mesenteric ischemia.

INTRODUCTION: Acute mesenteric ischemia (AMI) is an abdominal-vascular emergency which is rare and has high mortality rates (60-80 %) due to late diagnosis (1-3). Although it is known that extravascular reasons like intestinal intussusception, volvulus, strangulated hernias and obstructions can cause intestinal gangrene, these are rarely the cause of AMI (1). MATERIALS AND METHODS: In this study, we used male Wistar-Albino rats weighing 250-300 grams obtained from Pamukkale University Experimental Research Laboratory. Animals were exposed to light-dark cycles for 12 hours and had free access to food and water. They were kept in cages for 7 days to stabilise their intestinal flora. In animals of group I, nothing was made other than taking 0.5 ml blood intracardially. In other animals, abdomen was reached with midline laparotomy and superior mesenteric artery (SMA) was located. In group II (operative control group), SMA was isolated and manipulated but was not ligated. In Group III (intestinal ischemia group), SMAwas isolated and ligated with 3/0 silk tie distally to the aorta. After this process, intestinal ischemia was achieved which was confirmed by paleness and pulselessness of intestines, caecum and right colon. Later on, abdomen was closed with double 3/0 polyglactin sutures. At postoperative 1st, 4th and 6th hours 0.5 ml blood was taken intracardially from the animals in groups II and III in order to quantify D-dimer and L-lactate levels. LABORATORY TESTS: D-dimer: Blood samples which were put into tubes containing sodium citrate, were seperated from plasma with centrifugation at 4000 rpm for 7 minutes.L-lactate: Blood L-lactate levels were determined from blood taken into capillary tubes with the help of immobilised enzyme electrode technology using YSI 1500 Sport portative lactate analyzer (Yellow Springs Instruments Inc., Ohio-USA). HISTOPATHOLOGIC VERIFICATION: Two cm long intestinal samples were taken from animals in which SMA was ligated in order to achieve mesenteric ischemia and these samples were fixed in 10 % formol. DISCUSSION: As a result, in rats with SMA occlusion serum D-dimer levels were not increased significantly when compared either in the group or with the basal values of the control group and values in operative control group. Therefore, it is concluded that D-dimer is not a useful marker for early diagnosis of AMI. On the other hand, it is revealed that blood L-lactate levels began to increase significantly following 4th hour of mesenteric ischemia and it is shown that this increase continued at the 6th hour. In addition, considering the utmost importance of the early diagnosis in patients with the clinical suspicion of AMI, L-lactate seems to be a suitable marker to use in emergency departments because it is achieved with a portable device that gives fast and accurate results. Nevertheless, our results are need to be supported by clinical studies with larger patient series (Tab. 2, Fig. 11, Ref. 39).

Elastosonographic strain index in thyroid nodules with atypia of undetermined significance.

AIM: In this study, we aimed to evaluate the diagnostic accuracy of elastosonography (ESG) scoring and strain ratio in patients who had atypia of undetermined significance (AUS) cytology and underwent surgery for thyroid nodules. MATERIALS AND METHODS: 250 patients were included in this study. They had at least one nodule in thyroid USG, underwent USG-guided FNAC according to the current guidelines and had AUS cytology according to the Bethesda system. Both elastosonographic color scoring and strain index were evaluated. RESULTS: A total of 270 nodules in 250 patients were evaluated. Histopathologically, 81 (30 %) nodules were malignant and 189 (70 %) were benign. According to the ESG, 10 (3.7 %) nodules were assigned a score of 1, while 13 (4.8 %) nodules were assigned a score of 5. All of the nodules with an ESG score of 1 were histopathologically benign and 92.3 % of the patients with ESG score 5 were in the malignant group. Median SI in the benign histopathologic group was significantly lower compared to malignant group [(2.58 (IQR = 2.35) vs. 14.54 (IQR = 10.71)]. The optimal SI cut-off value to distinguish between the benign and malignant nodules was 6.66, with a sensitivity of 98.77 % and specificity of 96.30 %. CONCLUSION: Our study is one of the first studies evaluating the role of SI for discriminating malignant and benign nodules with AUS cytology. Malignant nodules had a significantly higher stiffness compared to benign ones and SI had high sensitivity, specificity, positive predictive value, negative predictive value and accuracy for these nodules. We think SI may be helpful for the presurgical selection of nodules with AUS cytology.

Episodic ozone exposure in adult and senescent Brown Norway rats: acute and delayed effect on heart rate, core temperature and motor activity.

Setting exposure standards for environmental pollutants may consider the aged as a susceptible population but the few published studies assessing susceptibility of the aged to air pollutants are inconsistent. Episodic ozone (O3) is more reflective of potential exposures occurring in human populations and could be more harmful to the aged. This study used radiotelemetry to monitor heart rate (HR), core temperature (T(c)) and motor activity (MA) in adult (9-12 months) and senescent (20-24 months) male, Brown Norway rats exposed to episodic O3 (6 h/day of 1 ppm O3 for 2 consecutive days/week for 13 weeks). Acute O3 initially led to marked drops in HR and T(c). As exposures progressed each week, there was diminution in the hypothermic and bradycardic effects of O3. Senescent rats were less affected than adults. Acute responses were exacerbated on the second day of O3 exposure with adults exhibiting greater sensitivity. During recovery following 2 d of O3, adult and senescent rats exhibited an elevated T(c) and HR during the day but not at night, an effect that persisted for at least 48 h after O3 exposure. MA was elevated in adults but not senescent rats during recovery from O3. Overall, acute effects of O3, including reductions in HR and T(c), were attenuated in senescent rats. Autonomic responses during recovery, included an elevation in T(c) with a pattern akin to that of a fever and rise in HR that were independent of age. An attenuated inflammatory response to O3 in senescent rats may explain the relatively heightened physiological response to O3 in younger rats.

A new echocardiographic parameter of arterial stiffness in end-stage renal disease.

BACKGROUND: Cardiovascular disease is the leading cause of death among patients with end-stage renal disease (ESRD). Arterial stiffness is an independent predictive parameter of overall and cardiovascular mortality in these patients. However, the defined procedures for the measurement of arterial stiffness are time consuming and not practical in daily practice. METHODS: The study population included 50 patients with ESRD who were treated with hemodialysis (HD; n=23) or peritoneal dialysis (PD; n=27) and 70 age- and sex-matched control subjects. Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and color M-mode propagation velocity of the descending aorta (aortic propagation velocity, APV) were measured. RESULTS: Compared to the control group, the patients with ESRD had significantly lower APV (46.4 ± 12.4 vs. 58.5 ± 8.5, p < 0.01) and higher PWV (10.5 ± 2.5 vs. 9.2 ± 1.2, p < 0.01) and CIMT (0.66 ± 0.15 vs. 0.43 ± 0.06, p < 0.01) measurements. There were significant correlations between APV and CIMT (r = - 0.769, p < 0.001), APV and PWV (r = - 0.682, p < 0.001), and PWV and CIMT (r = 0.564, p < 0.001). There were no significant differences in APV and PWV between the PD and HD patients. CONCLUSION: Arterial stiffness is an important indicator of atherosclerosis and arterial aging in patients with ESRD. The measurement of APV is an easy and practical new echocardiographic method and may be used to identify arterial stiffness in these patients.

Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes.

In vitro motility changes in Roux limb after Roux-en-Y reconstruction.

BACKGROUND: The aim of this study is to compare the motility of Roux limb with that of normal segment. MATERIALS AND METHODS: Rats were divided into 3 equal groups as control, Roux-en-Y (Group A) and Roux-en-Y with vagotomy (Group B). Only midline incision and manipulations were applied in control group. Following distal gastrectomy, Roux-en-Y reconstruction was applied in Group A, while vagotomy Roux-en-Y gastrojejunostomy was applied in Group B. Rats were sacrificed 1 month later by cervical dislocations under anesthesia. The obtained jejunal segments were cut into four equal parts. The bath was 37 °C warm while 95 % O2 and 5 % CO2 gases were supplied in 10 ml bicarbonate Krebs' solution. RESULTS: KCl responses were similar in all three groups. Acetylcholine contraction responses in the vagotomy and non-vagotomy Roux-en-Y groups was higher than in those in control group significantly (p < 0.05). This response in vagotomy Roux-en-Y group was also higher than that in non-vagotomy group (p < 0.05). The induced electrical field stimulation contraction response in the vagotomy + Roux-en-Y group was lower than those in control group and non-vagotomy group (p < 0.05). CONCLUSIONS: These results show that muscarinic receptor density and/or function may increase after vagotomy and non-vagotomy group operation, and vagotomy may contribute to this increase. The decrease in electrical signal response in vagotomy Roux-en-Y group may depend on the decrease in acetylcholine oscillation from the cholinergic nerve ending (Tab. 1, Fig. 5, Ref. 25).

Polypropylene mesh repair of incarcerated and strangulated hernias: a prospective clinical study.

PURPOSE: There is a common doubt regarding the application of polypropylene mesh to treat incarcerated and strangulated hernias due to the possibility of surgical site infection. We aimed to investigate the results of mesh repair of incarcerated and strangulated hernias, and to evaluate the incidence of wound infection and recurrence. METHODS: One hundred and fifty-three consecutive patients with incarcerated and strangulated hernias underwent surgery with mesh repair. The patients were divided into two groups: a resection group and a nonresection group. Fisher's exact test, the Chi-square test and independent samples t test were used to determine the statistical significance level (p < 0.05). RESULTS: While 53 patients required organ resection, the remaining 100 patients did not. The most frequently incarcerated organs were the omentum (86), small bowel (74) and colon (15). Most of the resections were performed in the omentum (36), small bowel (23) and colon (2). While five of the 53 patients (9.4%) in the resection group developed wound infections, no infections were observed in the nonresection group (p = 0.004). The infection rate in all patients was 3.3% (five of 153 patients). None of the infected patients required mesh removal. There were no mortalities or recurrence in either group. CONCLUSIONS: The findings revealed effective and safe usage of mesh along with antibiotic therapy in patients undergoing incarcerated and strangulated hernia repair.

Treatment of pilonidal disease by combination of pit excision and phenol application.

AIM: To examine the results of our minimal invasive treatment for pilonidal disease. METHODS: Total 83 patients treated by pit excision and consecutive phenol applications on an outpatient setting. All procedures were performed under local anesthesia, without any preoperative testing, colon cleansing, prophylactic antibiotics or sedation. A pit excision (mean length 1.3 ± 0.5 cm) including several close midline orifices was done. Separated pit excisions were done to the remaining midline and lateral orifices. Sinus cavity was cleared of hair and debris, and the walls of the cavity were sclerosed using a cotton bud dipped in 80% liquid phenol. Phenolization was repeated twice on day one and seven. RESULTS: Mean procedure time was 22.2 ± 7.4 min. Rates of patients who did not required analgesics at first, second, third and fourth days after surgery were 58, 85, 91 and 100%, respectively. All the patients returned to work/school after 3 days. Mean wound closure time was 28.5 ± 14.9 days. Total 86.7% of the patients were asymptomatic after a mean 25.7 ± 8.5 months follow-up. CONCLUSION: Simple pit excision and sclerosing the pilonidal sinus cavity consecutively was an effective and minimal invasive method for relief of pilonidal symptoms.

Methods for increasing distal radial artery diameter.

OBJECTIVE: Our study aimed to find the maximum rate of increase in distal radial artery size. PATIENTS AND METHODS: Diameter measurements were obtained on transverse and sagittal sections of the artery with a high-frequency linear transducer (Philips ClearVue L12-4 Mhz). In the baseline evaluation, radial artery and distal radial artery diameters were measured. The patients were divided into two groups: patients with flow-mediated dilatation in Group I and patients with 30 mg Topical Nitroglycerin in Group II. Group II patients were divided into two groups 30 minutes after topical nitroglycerin; patients with flow-mediated dilatation (FDM) in Group IIa, patients with wrist warming plus FMD in Group IIb. RESULTS: A significant increase was found between baseline and second measurements in the radial artery (2.64±0.46 and 2.36±0.39 mm; p=0.02 in Group I, 2.78±0.38 and 2.39±0.25 mm; p=0.01 in Group II) and distal radial artery (2.29±0.49 and 1.93±0.37 mm; p=0.02 in Group I, 2.32±0.28 and 1.96±0.44 mm; p=0.04 in Group II) diameters. Radial (3.02±0.55 and 2.78±0.38 mm; p<0.01) and distal radial artery (2.55±0.32 and 2.32±0.28 mm; p=0.01) diameters increased compared to the second measurements in Group IIa. Radial (3.25±0.35 and 2.78±0.38 mm; p<0.01) and distal radial artery (2.88±0.12 and 2.32±0.28 mm; p<0.01) diameters increased compared to the second measurements in Group IIb. The results of the final evaluations of the two groups were compared, radial (3.02±0.55 and 3.25±0.35 mm; p=0.04) and distal radial artery (2.55±0.32 and 2.88±0.12 mm; p=0.03) diameters were found to be significantly higher in Group IIb than Group IIa. When comparing baseline and final evaluations, the radial artery diameter was increased by 37%, and the distal radial artery diameter was increased by 49% in Group IIb. CONCLUSIONS: We increased the radial artery diameter higher proportion than defined in the literature.

The usefulness of tumor necrosis factor-like weak inducer of apoptosis in patients with acute ST-elevation myocardial infarction.

OBJECTIVE: We aimed to determine the utility of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) for the early diagnosis and prognosis of acute ST-elevation myocardial infarction (STEMI). PATIENTS AND METHODS: Patients presented with STEMI arrived at the hospital within 45 minutes after the onset of chest pain were included in this study. Blood samples for TWEAK, high-sensitivity C-reactive protein (hs-CRP), creatine kinase MB isoenzyme (CK-MB), and high-sensitivity cardiac troponin T (hs-TnT) levels were obtained at the time of arrival at the hospital. Subsequent samples were drawn at 4 h after primary percutaneous coronary intervention. RESULTS: The study cohort comprised patients with confirmed STEMI between January 2022 and September 2022, for a total of 45 enrolled STEMI patients. Plasma TWEAK levels were markedly elevated at hospital arrival, followed by a decrease at 4 hours after successful primary percutaneous coronary revascularization (PPCI). High-sensitive troponin T (Hs-TropT), CK-MB, and CRP were found within normal limits at the hospital arrival. Conversely, increased levels of CRP, CKMB, and hs-TropT were observed at 4 hours after PPCI. CONCLUSIONS: Plasma TWEAK levels were elevated earlier in the acute phase and decreased earlier after PPCI than other classic myocardial biomarkers.

The importance of GRACE risk score in the development of high-grade atrioventricular conduction blocks after non-st-segment elevation myocardial infarction.

OBJECTIVE: The development of high-grade atrioventricular block (HG-AVB) after acute coronary syndrome (ACS) increases morbidity and mortality rates. A significant portion of HG-AVBs resolve spontaneously after revascularization. We aimed to evaluate the power of the GRACE scoring system in predicting the development of HG-AVB and its importance in determining the need for cardiac pacemakers. PATIENTS AND METHODS: Patients who applied to our center between July 2020 and February 2023 were included in the study. 600 patients [340 (56.6%) male, mean age 65.4±13.6] without ST-segment elevation (NSTEMI) and who underwent revascularization were evaluated within the scope of the study. The heart rhythms of the patients were evaluated from the electrocardiograms (ECG) at admission. Patients with HG-AVB and other patients were divided into two groups. The heart rhythms of these patients were evaluated during their hospitalization. Then, HG-AVB patients were also divided into two groups (with and without PPM need). Demographic, laboratory, angiographic, and echocardiographic characteristics of these patients were evaluated. RESULTS: Morbidity and mortality were higher in the HG-AVB group. These patients had longer intensive care and hospital stays. The mean age, creatinine value, GRACE score (GS), total cholesterol (TC), and RCA lesion rates were higher in the HG-AVB group; hemoglobin level was found to be lower. As a result of regression analysis, RCA lesion, hemoglobin value, GRACE score, creatinine, and TC levels were predictors of HG-AVB development. In determining the need for PPM, these variables were found to be effective. ROC analysis was performed for GS, which predicted the development of HG-AVB, and the cut-off value was found to be 185.5. CONCLUSIONS: The development of HG-AVB after NSTEMI is an important health problem. By detecting these patients and those who may need PPM beforehand, various complications can be prevented, and the length of stay in the hospital can be shortened. Calculation of GS is an important parameter that can be used to predict the development and course of HG-AVB.

A bibliometric perspective with research trends and global productivity on the modernization of andrology from the founder of modern clinical andrology Edward Martin to the present.

OBJECTIVE: The number of studies in the field of andrology is increasing day by day, but a bibliometric study covering the entire literature on andrology has not yet been conducted. This bibliometric study aims to shed light on the question of where we came from and where we are going in andrology from past to present. It also aimed to summarize the intellectual structure of andrology to reveal global productivity and identify and map the latest trends of scientific articles published in the field of andrology. MATERIALS AND METHODS: 16,659 articles published between 1980 and 2022 were extracted from the Web of Science and analyzed using various statistical methods. Bibliometric network visualization maps revealed trending topics, global productivity, the most influential studies, and international collaborations. Spearman's correlation analysis was used for determining correlations. RESULTS: The top three productive countries were United States of America (3,452; 20.7%), China (2,300; 13.8%), and Germany (1,069; 6.4%). The top two most productive authors were Agarwal A. (n=130) and Nieschlag E. (n=130). The most productive institution was the Egyptian Knowledge Bank (n=422). From past to present, the most studied subjects were testis, male infertility, spermatozoa, testosterone, infertility, erectile dysfunction, spermatogenesis, sperm, prostate cancer (PCA)/neoplasms, oxidative stress, fertility/fertilization, semen, rat(s), apoptosis, azoospermia, sperm motility, human and varicocele. CONCLUSIONS: The trend topics that have been researched more in recent years include erectile dysfunction, oxidative stress, prostate cancer, sperm quality, sperm parameters, infertility, premature ejaculation, diabetes mellitus, obesity, prognosis, sperm DNA fragmentation/damage, antioxidant, asthenozoospermia, varicocelectomy, COVID-19, inflammation, prostatectomy, metabolic syndrome, hypogonadism, benign prostatic hyperplasia, lower urinary tract symptoms, meta-analysis, sexual dysfunction, peyronie's disease, and proliferation. We identified the research leadership of China, Japan, Turkey and India, in addition to Western countries, such as the USA and European countries.

Investigation of the effectiveness of prone ventilation in patients followed up for acute respiratory distress syndrome in the intensive care unit.

OBJECTIVE: Prone positioning has been found to improve oxygenation in most patients with acute respiratory distress syndrome (ARDS). The study aimed to investigate the effectiveness of the prone position in patients with ARDS. PATIENTS AND METHODS: The prone position is one of the ventilator techniques included in recent guidelines for acute respiratory distress syndrome. This study was a retrospective evaluation of the records of 100 ARDS patients who were administered prone position mechanical ventilation in our intensive care unit. All patients were placed in the prone position for a total of 12 hours per day at 4-hour intervals (supine-prone) while admitted to the intensive care unit. RESULTS: This study included 100 participants. These patients were divided into two groups as survivors [(n=38, 16 females, 22 males, median age: 60 (24-86)] and non-survivors [(n=62, 19 females, 43 males, median age: 64 (21-93)], according to their intensive care follow-ups. Acute physiology and chronic health evaluation (APACHE) II score, the sequential organ failure assessment score (SOFA), and inflammation markers were statistically significantly higher in the non-survivor group. Between the two groups, there was no statistically significant difference in terms of fundamental characteristics. In the sub-group evaluation of the subjects in patients with ARDS with and without novel coronavirus disease 2019 (COVID-19) groups, the patients in the COVID-19 (+) group were older, had shorter hospital stays, had higher APACHE II and SOFA scores, and higher rates of cardiovascular disease and sepsis. CONCLUSIONS: Applying prone-position mechanical ventilation in the cohorts of our patients with ARDS resulted in a demonstrable significant improvement in the oxygenation levels of our patients.