Remote learning during COVID-19: cognitive appraisals and perceptions of english medium of instruction (EMI) students.

Many countries responded to the Covid-19 pandemic by transforming all face-to-face (F2F) courses to emergency remote teaching with a sudden decision. This rapid shift was unexpected and staggering for the university students. The purpose of the present study is to explore how students studying in English Medium Instructed (EMI) programs cognitively appraised the transformation from F2F to online learning, and to examine if there is any relation between perceived self-efficacy in academic second language (L2) use, quality of interaction, and course satisfaction. Using an online survey, data was collected from a total of 306 graduate and undergraduate students studying in different universities in Turkey. The study found that the majority of the students appraised the transformation as a threat. The students' cognitive appraisals and perceived level of interactional quality, and satisfaction negatively correlated. There was a strong positive correlation between the perceived level of interactional quality and satisfaction. Observed gender, major and year level differences are also reported. The findings have significant implications for decision makers and instructors. Universities are likely to continue remote teaching for a while, thus institutions need to capture how students are affected by the remote learning experience to envisage short and long-term scenarios, and to optimize the quality of their services accordingly.

Does atopy affect the course of viral pneumonia?

BACKGROUND: The presence of atopy is considered as a risk factor for severe respiratory symptoms in children. The objective of this study was to examine the effect of atopy on the course of disease in children hospitalised with viral pneumonia. METHODS: Children between the ages of 1 and 6 years hospitalised due to viral pneumonia between the years of 2013 and 2016 were included to this multicentre study. Patients were classified into two groups as mild-moderate and severe according to the course of pneumonia. Presence of atopy was evaluated with skin prick tests. Groups were compared to evaluate the risk factors associated with severe viral pneumonia. RESULTS: A total of 280 patients from nine centres were included in the study. Of these patients, 163 (58.2%) were male. Respiratory syncytial virus (29.7%), Influenza A (20.5%), rhinovirus (18.9%), adenovirus (10%), human metapneumovirus (8%), parainfluenza (5.2%), coronavirus (6%), and bocavirus (1.6%) were isolated from respiratory samples. Eighty-five (30.4%) children had severe pneumonia. Atopic sensitisation was found in 21.4% of the patients. Ever wheezing (RR: 1.6, 95% CI: 1.1-2.4), parental asthma (RR: 1.5, 95% CI: 1.1-2.2), other allergic diseases in the family (RR: 1.8, 95% CI: 1.2-2.9) and environmental tobacco smoke (RR: 1.6, 95% CI: 1.1-3.5) were more common in the severe pneumonia group. CONCLUSIONS: When patients with mild-moderate pneumonia were compared to patients with severe pneumonia, frequency of atopy was not different between the two groups. However, parental asthma, ever wheezing and environmental tobacco smoke exposure are risk factors for severe viral pneumonia in children.

Detection of Candida species by nested PCR method in one-humped camels (Camelus dromedarius).

Systemic fungal diseases are the infections caused by false treatment protocols and generally are not taken into consideration especially in the veterinary field. One-humped camels are found in the western side of the Aegean region of our country and bred for wrestling. The aim of this study is the application of diagnosing systemic fungi infection from camel blood samples by the PCR method. In this study, specific primers for DNA topoisomerase II gene sequences were used. As a result, a systemic fungal infection was detected by the nested PCR method from 10 (20%) out of 50 DNA samples taken from camels located on the western side of the Aegean region. In this study, 3 (30%) samples were identified as Candida albicans, 3 (30%) samples were identified as C. glabrata, and 4 (40%) samples were identified as C. parapsilosis. In conclusion, the 20% positive systemic fungal infection rate in one-humped camels observed in the present study showed that the systemic fungal infections are not taken into considerations in veterinary medicine. Further studies are suggested in order to obtain and to maintain extensive data for systemic fungal diseases in our country for one-humped camels.

Status and awareness of cervical, breast, and colon cancer screening in a Turkish city.

PURPOSE OF INVESTIGATION: Mortality and morbidity rates of cervical, breast, and colorectal cancers (CRC) can be decreased via effective screening strategies. Developing countries are to be expected to establish and implement their own programs. MATERIALS AND METHODS: To evaluate regional awareness and status of cervical, breast, and CRC screening, a questionnaire-based study was conducted in 500 volunteers from a Turkish community hospital. RESULTS: Awareness rates were 57.4% for Pap smear, 61.2% for mammography, and 25.4% for CRC. Implementation rates were 19.2%, 23.9%, and 12%, respectively. Positive family history for gynecologic cancer and past cervical ablative procedure parameters were related to higher Pap smear rates. Educational level, breast self-exam, and positive Pap smear history parameters were related to higher mammography rates. Factors related to higher colorectal cancer screening rates were nulliparity and positive Pap smear history. CONCLUSION: Cancer screening rates for this Turkish city are still below the expected levels despite recently revitalized national screening program. For success, it is essential not only to educate rural populations but also to train negligent healthcare providers regularly.

Predictive value of procalcitonin and IL-6 versus cervical length for the admission-to-delivery interval in preterm labour.

OBJECTIVE: The authors aimed to determine whether concentrations of IL-6 and procalcitonin in maternal circulation can be used and compared with cervical length to predict the admission-to-delivery interval in preterm labour. MATERIALS AND METHODS: Forty patients complicated with preterm labour between 24-34 weeks of gestation and having preterm birth were included in the study group. Fortyfour healthy pregnant women at similar gestational ages and having term labour ('> 37 weeks) were included in control group. Maternal concentrations of IL-6 was measured by an enzyme-linked immunosorbent assay (ELISA) and procalcitonin was measured by immunoturbidimetry with using human procalcitonin reagent kit. Transvaginal ultrasound to assess cervical length was perforned. RESULTS: Receiver operator characteristic (ROC) analysis results of IL-6 and procalcitonin for prediction of preterm delivery (PTD)< 48 hours, < seven days, <32 weeks, < 34 weeks, and < 37 weeks were not statistically significant (p > 0.05). ). It was shown through ROC analysis, that only cervical length had area under curve (AUC) 0.692 (0.511-0.873,p = 0.044) at cut off value ≤ 3.64 cm, AUC 0.758 (0.574-0.943, p = 0.015) at cut off value ≤ 3.50 cm, AUC 0.716 (0.553-0.879,p = 0.032) at cut off value < 3.80 cm, in predicting PTD within seven days, <32 weeks and < 37 week, respectively. CONCLUSION: This study suggests that in preterm labour, although IL-6 and procalcitonin have unsatisfactory predictive value for the admission-to-delivery interval, cervical length has better predictive values for the admission-to-delivery interval.

The effects of the sagittal plane malpositioning of the patella and concomitant quadriceps hypotrophy on the patellofemoral joint: a finite element analysis.

PURPOSE: Anterior knee pain is a common symptom after intramedullary nailing in tibia shaft fracture. Moreover, patellofemoral malalignment is also known to be a major reason for anterior knee pain. Patellofemoral malalignment predisposes to increased loading in patellar cartilage. In the previous study, we have demonstrated the quadriceps atrophy and patellofemoral malalignment after intramedullary nailing due to tibia shaft fracture. In this study, our aim was to clarify the effects of quadriceps atrophy and patellofemoral malalignment with the pathologic loading on the joint cartilage. METHODS: Mesh models of patellofemoral joint were constructed with CT images and integrated with soft tissue components such as menisci and ligaments. Physiological and sagittal tilt models during extension and flexion at 15°, 30° and 60° were created generating eight models. All the models were applied with 137 N force to present the effects of normal loading and 115.7 N force for the simulation of quadriceps atrophy. Different degrees of loading were applied to evaluate the joint contact area and pressure value with the finite element analysis. RESULTS: There was increased patellofemoral contact area in patellar tilt models with respect to normal models. The similar loading patterns were diagnosed in all models at 0° and 15° knee flexion when 137 N force was applied. Higher loading values were obtained at 30° and 60° knee flexions in sagittal tilt models. Furthermore, in the sagittal tilt models, in which the quadriceps atrophy was simulated, the loadings at 30° and 60° knee flexion were higher than in the physiological ones. CONCLUSIONS: Sagittal malalignment of the patellofemoral joint is a new concept that results in different loading patterns in the patellofemoral joint biomechanics. This malalignment in sagittal plane leads to increased loading values on the patellofemoral joint at 30° and 60° of the knee flexions. This new concept should be kept in mind during the course of diagnosis and treatment in patients with anterior knee pain. Definition of the exact biomechanical effects of the sagittal tilting will lead to the development of new treatment modalities.

Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing.

PURPOSE: The aim of the study was to analyse the patellofemoral alignment in the sagittal plane following tibial fracture surgery with intramedullary nailing and its relationship to parapatellar muscle status. METHODS: The patellofemoral MRI results of 27 patients (15 males and 12 females) treated with locked intramedullary nailing following tibia shaft fracture were reviewed. The mean age of the patients was 41.8 (±15) years. The patella-patellar tendon angle (P-PT) and the distance between the inferior patellar pole and the tibial tubercle (DP-TT) were evaluated for both the operated extremity and the contralateral normal side. MRI assessment of the infrapatellar fat pad, quadriceps, sartorius, gracilis, semi-membranosus muscles and biceps muscles was also carried out. The correlation between the changes in skeletal muscle mass, the volume of the infrapatellar fat pad and the alterations in the DP-TT distances and P-PT angles were analysed. RESULTS: The quadriceps muscle cross-sectional diameter had a mean of 157.2 mm(2) (115.6/319.5) in the operated extremity, and it was 193 mm(2) (77.6/282.2) in the non-operated normal side (p = 0.001). For the Gracilis muscle, the mean was 84.4 mm(2) (19.7/171) at the operated extremity and 75.7 mm(2) (26.9/238.2) on the normal side (p = 0.05). The cross-sectional areas of the semi-membranosus, sartorius and biceps muscles in the operated and non-operated extremity were not noticeably different (n.s). The P-PT angle was 153° (129.7/156.4) in the operated extremity and 145.7° (137.6/163.4) in the non-operated normal extremity (p < 0.05). While DP-TT distance was 11.4 mm (9.4/20.4) in the operated extremity, it was 14.1 mm (7.3/17.1) in the non-operated extremity (p = 0.001). The correlation analyses revealed that the quadriceps hypotrophy negatively correlated (r = -0.4, p = 0.02) with the P-PT angle but positively correlated with the increase in gracilis muscle volume (r = 0.4, p = 0.03). CONCLUSION: This study revealed that patellofemoral joint kinematics in the operated extremity was diminished in the sagittal plane correlating with the quadriceps muscle volume loss and gracilis muscle hypertrophy. The modalities focused on both preventing and treating the hypotrophy of the quadriceps muscle following the surgical treatment of tibial fracture, which may help to overcome this quite common pathology.

Impacts of maternal anxiety on non-stress test parameters.

OBJECTIVE: To determine the association between antenatal maternal anxiety with non-stress test (NST) parameters, which is an indi- cator test of fetal well-being in the third trimester. MATERIALS AND METHODS: Between January and December of 2013, 212 pregnant women, with 36-41 weeks of gestation were assessed with measures of distress and anxiety with Beck Anxiety Inventory (BAI) and with NST. The new National Institute Child Health and Human Development (NICHD) 2008 guideline criteria were used for interpretation of NST. Anxiety scores were grouped as minimal, mild, moderate, and severe. The impact of anxiety on NST parameters were investigated. RESULT: Anxiety scores were inversely correlated with fetal heart rate (FHR) accelerations (r = -0.631, and r = -0.855), number of fetal movements (r = -0.633, r = -0.860), FHR variability scores (r = -0.650, r = -0.877). and NST scores (r = -0.505, r = 0.729), (for all p < 0.001). NST scores were lower in severe anxiety group than the others. CONCLUSION: The study showed that severe form of anxiety significantly affects NST parameters in near-term pregnancies.

Prognostic utility of serum vitronectin levels in acute myocardial infarction.

BACKGROUND: Vitronectin (VN) functions as a regulator of platelet adhesion and aggregation, coagulation, and fibrinolysis. The aim of this study was to assess the prognostic significance of serum VN levels in patients with acute myocardial infarction (MI). METHODS: In this study 62 patients admitted with ST-elevation myocardial infarction (STEMI), or non-ST-elevation myocardial infarction (NSTEMI) were enrolled. Serum VN levels were measured within 6 h after onset of chest pains. RESULTS: The VN serum levels were higher in MI patients with a mean of 2.257 µg/ml (range 1.541-4.493 µg/ml) in the STEMI group, 1.785 µg/ml (range 1.372-4.113 µg/ml) in the NSTEMI group, and 1.222 µg/ml (range 1.033-1.466 µg/ml) in the controls (p = 0.012). Major adverse cardiovascular events could be predicted at 6 months using VN levels independently of other variables [odds ratio (OR) 9.87, 95 % confidence interval (CI) 2.54-47.37, p = 0.001]. There was a significant positive correlation between VN levels and the Gensini score in NSTEMI patients (r = 0.436, p = 0.013). CONCLUSION: The VN level may be relevant as a clinical biomarker for adverse cardiovascular outcomes not only in patients with ischemic heart disease undergoing coronary interventions, as previously reported, but also in coronary artery disease patients presenting with acute MI.

Comparison of diagnostic methods for evaluation of postmenopausal bleeding.

OBJECTIVE: To determine and compare diagnostic accuracy parameters of saline infusion sonohysterography (SIS), transvaginal ultrasonography (TVUSG), and hysteroscopy (H/S) based on histopathologic results which are accepted to be the gold standard in patients with postmenopausal bleeding (PMB). MATERIALS AND METHODS: Forty-seven patients who applied to Gynecology clinic of Adnan Menderes University, School of Medicine with PMB complaint aged between 43-76 years were included to the study. Fractioned curettage (F/C) and H/S guided biopsy were used for endometrial sampling. Diagnostic accuracy parameters (sensitivity, specificity, and positive and negative predictive values) of different methods; TVUSG, SIS, and H/S based on histopathologic findings were investigated. RESULTS: Specificity and sensitivity values calculated based on histopathologic results for all endometrial cavity lesions were found, respectively: 44.4% and 25% for TVUSG, 88.8% and 60.7% for SIS, and 100% and 77.7% for HIS. CONCLUSION: SIS is superior to TVUSG and as effective as H/S for assessment of endometrial cavity lesions in patients with PMB.

Posterior reversible encephalopathy syndrome in obstetric patients. Report of three cases with literature review.

Posterior reversible encephalopathy syndrome (PRES) is a serious clinico-neuroradiological maternal complication in pregnancy. Although it has various etiologies such as hypertensive encephalopathy, renal failure, autoimmune disorders, sepsis, multiple organ failure, and treatment with immunosuppressant or cytotoxic agents, pregnancy and postpartum complicated by hypertensive disorders more frequently lead to this condition. PRES is clinically characterized by headache, confusion, seizures, vomiting, and visual disturbances with radiographic vasogenic edema especially affecting symmetrical parietal and occipital lobes. The underlying pathophysiology is still a matter of debate. Prompt recognition and early intervention greatly improve the prognosis, so that obstetricians should be well aware of this rare entity. Timely imaging is of crucial importance especially in patients with an uncertain diagnosis for determining the appropriate treatment and preventing the possible development of neurologic deficits. In the present report, three cases of PRES are presented with clinical and radiological findings in pregnancies complicated by severe pre-eclampsia and eclampsia. The latest literature in the field is also carefully reviewed.

Protective Effects of Carvacrol Against Methotrexate-induced Liver Toxicity in Rats.

BACKGROUND: To investigate whether carvacrol (CAR) pretreatment reduces the severity of methotrexate (MTX)-induced hepatotoxicity in rats. METHODS: A total of 24 rats were equally divided into three groups : group I, control ; group II, MTX-treated ; and group III, CAR+MTX-treated. On Day 1 group III received a one-time intraperitoneal dose of CAR (73 mg/kg), and on Day 2 both groups II and III received a single dose of intraperitoneal MTX (20 mg/kg). The rats were then sacrificed so to harvest blood and liver tissue samples to determine malondialdehyde (MDA), total antioxidant capacity (TAS), total oxidant status (TOS), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels. Histological specimens were examined via light microscopy. RESULTS: Levels of MDA, ALT, AST and ALP in rat liver tissue samples were significantly higher in the MTX-treated group relative to the control group. However, TAS was significantly reduced in the MTX-treated group when compared to controls. Pretreating rats with CAR counteracted the effect of MTX exposure as MDA was significantly decreased and TAS was elevated in liver tissues when contrasted with the MTX-treated group. Furthermore, histological examination demonstrated significant liver injury in the MTX-treated group versus the CAR+MTX group. CONCLUSIONS: Pretreatment with CAR markedly diminished liver damage induced by MTX. Therefore, CAR administration preceding MTX treatment might be a promising therapeutic modality to prevent and/or lessen the extent of MTX-induced hepatotoxicity.

Experimental investigation of relationship between trauma and bisphosphonate-related osteonecrosis.

BACKGROUND: Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) disease is rare, but there are serious side-effects of BP therapy in patients. In some patients, surgery is needed and could not be cured. A standard test is not available showing the risk of jaw osteonecrosis in routine use. The measurement of serum C-terminal telopeptide (CTX) levels has been used in diseases of BRONJ resorption and antiresorptive therapy. AIM: This paper is aimed at investigating the relationship between traumatic procedures and presence of BP-related osteonecrosis. MATERIALS AND METHODS: Thirty male Wistar albino rats with weighing 200 ± 20 g were used for the experimental procedures. Rats were randomly divided into three groups each containing 10 rats as follows: Group 1 (traumatic extraction group), Group 2 (atraumatic extraction group), and Group 3 (control group). All groups, zoledronic acid (ZA) (0.3 mg/kg/week) [1] was diluted with physiological saline and given subcutaneously for 2 months. After the 2 months, Group 1 was subjected to traumatic extraction of right first lower molars, and Group 2 was subjected to atraumatic extractions of the right first lower molars. Group 3 was subjected to no extractions as a control group. Animals were euthanized 32 days after tooth extractions, and the ZA administration protocol was maintained until the animals' death. After sacrifice, blood samples were collected for C-terminal cross-linking telopeptide of type I collagen (CTX-1) levels, clinical and radiological findings were recorded. RESULTS: The bone resorption marker CTX-1 showed a significant difference among the groups. CTX-1 was measured significantly higher in blood samples of Group 2 (4.15 ± 0.34; P = 0.001) than Group 1 (3.77 ± 0.34; P = 0.0001). No, statistically significant changes were found between Groups 1 and 2 as for clinical and radiological assessment. CONCLUSION: This study provides preliminary observations for the development of an animal model of BRONJ. Although clinical and radiological findings were not relevant, serum CTX values are reliable biochemical markers for predicting BRONJ and also atraumatic surgical procedures are important to prevent BRONJ.

Heritability and genetic correlations of rumination time with milk-yield and milking traits in Holstein-Friesian cows using an automated milking system.

Knowledge of the values of genetic parameters is a prerequisite for conducting a breeding program. This is especially important for rumination, which is considered an indicator of cow's health. Exploring the genetic relations between rumination time, milk yield, and milking traits could make it a valuable tool in dairy cattle breeding strategies. The objective of the research was to estimate heritability, repeatability, and genetic and phenotypic correlations of rumination time (RT), as well as traits associated with milk yield and milking of dairy cows of the Polish Holstein-Friesian breed kept in herds equipped with an automatic milking system. The research takes into consideration daily results for milking in the first lactation and second lactation, from 1 486 cows of the breed milked between 2013 and 2015 year. Cows were housed in 24 free-stall barns and fed a Partial Mixed Ration feed. The barns had an automated milking system (Astronaut A4 - Lely Industry). The cows received a varied dose of the concentrate, either in the milking robot or the feeding station, depending on the level of their milk yield. Our research has shown that RT was a low heritable trait (0.140 ± 0.039) and had a medium repeatability (0.572 ± 0.007). We detected a positive genetic correlation between RT and milk yield (0.341); however, a statistically significant negative relationship was identified between RT and urea content (-0.418) in milk. Estimations of genetic correlations suggest that selecting for higher RT may correspond to reduced urea content in milk. Investigating the genetics aspect of RT and the relationship with milk yield and milking traits may turn this into one of the useful criterion selections for dairy cattle breeding strategies, but should be used carefully. Further analyses on larger data sets and different populations are necessary.

Fibrosis in heart failure subtypes.

BACKGROUND: The differences in concentrations of biomarkers between heart failure patients with dilated cardiomyopathy (HF-D) and with ischemic cardiomyopathy (HF-I) have yet to be defined. The objectives of this study were to compare the concentrations and correlation of biomarkers of inflammation, extracellular matrix (ECM) turnover and oxidative stress parameters between these populations. PATIENTS AND METHODS: Our study consisted of 36 subjects with HF-D (LVSD = 47.2 ± 7.3 mm, LVDD = 65.1 ± 6.3 mm), 44 subjects with HF-I (LVSD = 38.0 ± 4.4 mm, LVDD = 58.5 ± 6.0 mm) and 38 controls without heart failure. Concentrations of matrix metalloproteinase (MMP)-1, MMP-2, MMP-9, MMP-13, Galectin-3, prolidase, TNF-alpha, and oxidative stress index (OSI) were measured. RESULTS: Serum levels of MMP-2, MMP-9, and prolidase were significantly increased in HF-I group compared to healthy controls (p = 0.039, 0.019, 0.012 respectively), whereas the increases in MMP-1 and MMP-13 were not significant. This significance was stronger in the HF-D group than the HF-I group (p = 0.004, 0.001, 0.002 respectively). TNF-α, a marker of inflammation, was significantly increased in heart failure (p = 0.004) but there was no difference between HF-D and HF-I groups; however, Galectin-3 was significantly increased in the HF-D group compared to the HF-I group (p = 0.005). OSI showed the same response pattern as TNF-α (p = 0.019, 0.002 respectively). There was a positive correlation of MMP-9 levels with prolidase activity (r = 0.612, p: 0.003). CONCLUSIONS: MMPs and Galectin-3 are important in cardiac remodeling; prolidase may share an undefined role in fibrosis in heart failure and may have a role in the diffuse fibrosis of heart failure.

Similar prevalence, different spectrum: IgE-mediated food allergy among Turkish adolescents.

BACKGROUND: Scarcity of reliable data on food allergy prevalence exists in Turkey. We aimed to assess reported and confirmed IgE-mediated food allergy prevalence, and define the spectrum of allergenic food. METHODS: We prospectively evaluated the ISAAC Phase II study population for food allergy. Participants that reported experiencing food allergy symptom in the last year and/or were skin prick test positive for a predefined list of food allergens, were interviewed via telephone, and those considered as having food allergy were invited to undergo clinical investigation, including challenge tests. RESULTS: A total of 6963 questionnaires were available. Parental reported food allergy prevalence and skin prick sensitisation rate were 20.2 ± 0.9% and 5.9 ± 0.6%. According to the above-defined criteria, 1162 children (symptom positive n=909, skin prick test positive n=301, both positive n=48) were selected and 813 (70.0%) were interviewed via telephone. Out of 152 adolescents reporting a current complaint, 87 accepted clinical investigation. There were 12 food allergies diagnosed in nine adolescents, with food allergy prevalence of 0.16 ± 0.11%. The most common foods involved in allergic reactions were walnut (n=3) and beef meat (n=2), followed by hen's egg (n=1), peanut (n=1), spinach (n=1), kiwi (n=1), cheese (n=1), hazelnut (n=1) and peach (n=1). CONCLUSIONS: While parental reported food allergy prevalence was within the range reported previously, confirmed IgE-mediated food allergy prevalence among adolescents was at least 0.16%, and the spectrum of foods involved in allergy differed from Western countries, implying environmental factors may play a role.

The protective effect of ellagic acid on lung damage caused by experimental obstructive jaundice model.

AIM: This study aimed to investigate protective effects of ellagic acid on lungs in an experimental obstructive jaundice model. METHODS: Four groups were established, each consisting of ten randomly selected rats: Group 1: sham, Group 2: ellagic acid, Group 3: obstructive jaundice, and Group 4: obstructive jaundice + ellagic acid. Ellagic acid was administered orally at a dose of 60 mg/kg/day to group 2 and 4. The animals were sacrificed eight days later. The total oxidative status and the total antioxidant capacity in their lung tissue were determined, and malondialdehyde levels in their blood were measured. Histopathological changes in the lungs were examined. RESULTS: In the obstructive jaundice group treated with ellagic acid, there was a decrease in malondialdehyde levels and a reduction in the total oxidative status and the oxidative stress index, whereas the total antioxidant capacity increased (p < 0.001). The histopathological examination showed that neutrophil leukocyte infiltration and edema formation decreased and destruction of lung parenchyma disappeared following the treatment with the ellagic acid (p < 0.05). CONCLUSION: This study shows that ellagic acid has a protective effect against oxidative damage in lung tissue in obstructive jaundice.

Coronary disease risk prediction algorithm warranting incorporation of C-reactive protein in Turkish adults, manifesting sex difference.

BACKGROUND AND AIM: An algorithm is needed for predicting coronary heart disease (CHD) risk in Turkish adults who have a high prevalence of metabolic syndrome (MetS). METHODS AND RESULTS: Ten-year risk of CHD was estimated in 2232 middle-aged adults free of CHD at baseline, followed over 7.6-years. Cox proportional hazard regression was used to predict CHD. Discrimination was assessed with area under receiver operating characteristics curve (AROC). CHD developed in 302 subjects. In multivariable analysis, high-density lipoprotein (HDL)-cholesterol levels were borderline predictive in men; smoking status and HDL-and low-density lipoprotein (LDL)-cholesterol levels were not predictive in women. Age, presence of diabetes, systolic blood pressure and C-reactive protein (CRP) were predictors in both sexes, while smoking status and LDL-cholesterol were so in men only. AROC of the model was 0.789 in men, and 0.806 in women (p < 0.001 each). An algorithm using the stated seven variables was derived separately for each sex. After age adjustment, men and women in the highest quintile of risk score were significantly and 20-27-fold more likely to develop CHD than those in the lowest quintile. CONCLUSIONS: In a population with prevalent MetS, low-grade inflammation is independently relevant for CHD, as are serum lipoproteins and smoking status. The derived algorithm is effective in estimating CHD risk among Turkish adults.

Pregnancy outcome of Moroccan and Turkish women in Belgium.

OBJECTIVE: To compare perinatal outcome in women from Turkish and Moroccan descent versus autochthonous women in Belgium. METHODS: Retrospective cohort study, data from an existing database, coupled with sociodemographic data from birth certificates. RESULTS: There were more teenage pregnancies in the Moroccan and Turkish group, Moroccan women delivered more frequently after age 40 but Turkish women less frequently. In Moroccan and Turkish women the level of education was lower, they had less hypertension, fewer pregnancies after artificial reproductive technology and preterm deliveries, more diabetes and more grand multiparity. Moroccan women demonstrated more HIV infection. Planned cesarean section was less frequent in the Moroccan and Turkish group, and there was no difference for secondary cesarean section. Belgian women had more induction of labor, instrumental vaginal delivery and epidural anesthesia. There were more babies with low birth weight in both the Moroccan and Turkish group. Moroccan woman had more babies with a birth weight above 4500 g. Total perinatal death rate was higher for Moroccan women while there was no difference between Belgian and Turkish babies. CONCLUSION: Moroccan women demonstrated higher rates of HIV infection and perinatal mortality, while in both Turkish and Moroccon women diabetes was higher and hypertension less frequent. Belgian women underwent more interventions during pregnancy.

Anaphylaxis in Turkish children: a multi-centre, retrospective, case study.

BACKGROUND: Anaphylaxis is a serious and potentially lethal systemic reaction affecting more than one organ or system. OBJECTIVE: We aimed to describe the demographic characteristics, clinical features, causes, settings, and administered therapy in Turkish children. METHODS: This retrospective, case note study included all children referred to the outpatient clinics of the Pediatric Allergy Departments of the participating study centres from 1 July 1999 to 30 June 2009 for investigation of anaphylaxis or who were seen by us at the moment of the reaction during the same period and who met the clinical criteria of anaphylaxis. RESULTS: Two hundred and twenty-four cases of anaphylaxis were reported in 137 children (88 boys, P = 0.0001). The mean ± SD age at the referral was 7.7 ± 4.2 years (range: 4 months-17 years). Ninety-eight episodes (43.8%) occurred at home. The symptoms were cutaneous in 222 (99.1%) episodes, respiratory in 217 (96.9%), neuro-psychiatric in 118 (52.7%), cardiovascular in 92 (41.1%), and gastrointestinal in 88 (39.3%). Biphasic reaction was reported in seven episodes (3.1%, 95% CI: 1.5-6.3). Death occurred in one case (0.4%, 95% CI: 0.08-2.4). Treatment was available in 158 episodes (70.5%). Of them, 148 (93.7%) received antihistamines, 132 (83.5%) corticosteroids, 51 (32.3%) epinephrine, and 17 (10.8%) beta-2-mimetics. The causative agents were foods in 86 (38.4%) episodes, hymenoptera venom in 84 (37.5%), drugs and medications in 47 (21.0%), and latex in 5 (2.2%). In two episodes (0.9%), the causative agent was unidentified. Allergy to the trigger was known prior to anaphylaxis in 116 (51.8%) episodes. An epinephrine auto-injector had been prescribed for 70 children (51.1%). CONCLUSIONS AND CLINICAL RELEVANCE: Anaphylaxis was seen significantly more in boys. Most of the reactions occurred at home. Foods were the most frequent cause. Epinephrine, the first-line treatment of anaphylaxis, was administered in only a third of the children.