Optimization of ultrasound-assisted aqueous two-phase system (ATPS) of phenolics from apple pulp and peel.

In this study, extraction of phenolic compounds from apple peel and pulp was optimized using an ultrasound-assisted aqueous two-phase system (UA-ATPS) consisting of acetone-NaH2PO4 and acetone-(NH4)2SO4 with the help of Response Surface Methodology. The effectiveness of UA-ATPS was compared with certain extraction methods including traditional aqueous two-phase system (T-ATPS), ultrasound-assisted acetone extraction (UA-ACE) and traditional acetone extraction (T-ACE). The UA-ATPS gave better results than traditional methods in terms of phenolic and flavonoid contents and antioxidant activity values regardless of the fruit parts used. The status of extraction yield was observed with three major phenolics of apple including chlorogenic acid, rutin and phloridzin. Striking increases in chlorogenic acid and rutin contents in the peel were determined when acetone was replaced with ATPS in the same extraction system with equal extraction time (20 min). The present study has indicated that UA-ATPS is an effective method for phenolic extraction from apple peel and pulp.

Determination of the effect of the dam age, birth type, and sex on growth curve traits of hair goat kids.

This study was conducted to investigate the best-fit growth curve and dam age, sex, and birth type effect on growth curve traits of hair goat kids. Monthly 3858 test day body weight (BW) records of 643 hair goat kids from birth to 150 days of age were used to determine the best-fit growth curve and estimate growth curve parameters with Gompertz and Von Bertalanffy models. The BW records were assigned to three groups: dam age (3, 4, 5, 6, 7 years), sex (female, male), and birth type (single, twin). The Gompertz model gave more consistent results than the Von Bertalanffy model according to the goodness of fit criteria. Dam age had no significant effect on any of the growth curve traits. Sex of kids showed a significant effect on maturity index (parameter K) (P < 0.001), estimated mature body weight (parameter A), and weight at point of inflection (IPW) (P < 0.01). Also, birth type had a significant effect on initial/birth weight (parameter B) and parameter K (P < 0.001). Age at point of inflection (IPT) was not affected by any of the factors. Twin kids had a higher maturity index than singles while females higher than males. In conclusion, the Gompertz model was the most suitable model for hair goat kids for selection strategies. For proper selection, the effect of sex and birth type on growth curve traits should be considered by hair goat breeders.

Peppermint leaves hydrodistillation by-products: bioactive properties and incorporation into ice cream formulations.

Distillation by-products of peppermint have not been considered for the valorization of bioactive compounds. In this study, by-products of peppermint after hydrodistillation, hydrosol and distilled leaves, were investigated followed by the most effective fraction was incorporated into ice cream formulations in order to improve the health promoting effects including antioxidant and α-glucosidase inhibition capacities of the ice creams. Distilled leaves of peppermint were subjected to sequential extraction by ethyl acetate and ethanol. HPLC analyses of eriocitrin and total phenolic analysis indicated that hydrosol contained significant amount of phenolics after 2 h hydrodistillation. Extending hydrodistillation from 1 to 2 h had insignificant effects on phenolic content. Distilled leaves of peppermint had extract yield of 7.39 and 7.19 g/100 mL in 1 and 2 h ethyl acetate extraction, respectively. The predominant phenolic of peppermint (eriocitrin) was 917.5 mg/L in hydrosol after 1 h distillation. Four h distillation of peppermint resulted in decrease in the amount of eriocitrin, however, hydrosol contained valuable amount of phenolics (840.1 mg/L). Hydrosols displayed higher antioxidant capacity in all tested methods than distilled leaves. Hydrosols, at equal amount of phenolics, had higher α-glucosidase inhibition capacity (5.92 µg/mL) than ethyl acetate extract (14.62 µg/mL) and ethanol extract (17.04 µg/mL) of deodorized leaves. Hydrosols were spray dried with the aid of maltodextrin in order to increase drying yield and incorporate the spray dried hydrosol (SDH) into ice cream formulations. Among others, ice cream incorporated with 0.5% of SDH was accepted by the panelists without damaging sensorial properties of ice cream.

Optimisation of spray drying process in microencapsulated cream powder production.

In this Research Communication we describe the optimisation of spray drying conditions in the production of microencapsulated cream powder. Oil-in-water emulsions were prepared using maltodextrin (18 DE) and sodium caseinate as wall materials (with the total wall material per total solid content ratio of 30%) and then converted into powder by spray drying. Response surface methodology was used to optimise the factors of spray drying system i.e. inlet drying temperature, feed flow rate, and aspiration rate, where the levels were in the range of 150-190°C, 9-30 ml/min, and 50-100%, respectively. Our objective was to perform spray drying with the highest drying yield and to obtain a microencapsulated cream powder with the highest bulk density, the shortest wetting time, and the lowest surface fat content. The calculated and validated optimum conditions for the spray drying process were found to be 162.8°C for inlet drying temperature, 11.51 ml/min for feed flow rate, and 72.8% for aspiration rate. At these optimum conditions, drying yield, bulk density, wettability, and surface fat content values were 36.37%, 269.9 kg/m3, 115.2 s and 26.2%, respectively.

Characterisation of peppermint (Mentha piperita L.) essential oil encapsulates.

Aim: The aim was to choose the optimal encapsulation system and to incorporate encapsulates loaded with essential oil into the ice cream as a model food product. Methods: Ca-alginate beads were produced by electrostatic extrusion process. Gelatine/alginate coacervates were processed with coacervation. Carnauba wax microparticles were produced using melt dispersion process. Morphological properties, chemical, and thermal stabilities of encapsulates were tested by SEM, FTIR spectral, and thermogravimetric analysis. Results: Alginate provided sufficient emulsion stability over 1 h. Ca-alginate showed higher encapsulation efficiency (EE) (98.4 ± 4.3%) compared to carnauba wax (94.2 ± 7.8%) and gelatine/alginate coacervates (13.2 ± 1.2%). The presence of essential oil in all three types of encapsulates confirmed with FTIR. The encapsulation process ensured controlled release and thermal stability of the oil. Conclusions: Ca-alginate matrix as the most suitable for peppermint essential oil encapsulation. The sensory analysis showed that ice cream incorporating encapsulates is a promising system for the consumption of health beneficial peppermint essential oil.

Simultaneous extraction of phenolics and essential oil from peppermint by pressurized hot water extraction.

Phenolics and essential oil of peppermint were obtained by pressurized hot water extraction (PHWE). The best extraction conditions were found to be 130 °C for temperature, 10 min for extraction time, and 3 cycles for extraction number. There were no statistically significant differences between 130 and 160 °C in terms of essential oil content. Total phenolic contents (TPC) of the extracts were higher at 160 °C than that of 130 °C. However, further HPLC analysis of the extracts revealed that hydrolysis and/or decomposition of phenolics were observed in the extracts obtained at 160 °C. The main phenolic of peppermint was determined as eriocitrin by HPLC-DAD, while menthol was the dominant component in essential oil fraction of peppermint by GC-FID. The present study demonstrated that PHWE was a suitable technique for simultaneous extraction of phenolics and essential oil from peppermint. The technique might be used as an analytical extraction tool for determination of phenolics and essential oil. Moreover, the extracts of PHWE could directly be evaluated for the enrichment of liquid food formulations or be transformed into solid form by suitable techniques such as spray drying for easy storage and subsequent enrichment of food products.

Phenolics of pomegranate peels: extraction optimization by central composite design and alpha glucosidase inhibition potentials.

Optimum water extraction conditions for phenolics of pomegranate peels were investigated by fractional factorial and face-centered central composite designs. Five potential factors were selected for the fractional factorial design: extraction technique, extraction temperature, extraction time, particle size and solvent to solid ratio. After eliminating statistically unimportant factors, a face-centered central composite design was set up with two controllable factors and with two responses: total phenolics and α-glucosidase inhibition activity. Optimum conditions were found as 100 °C for extraction temperature and 1 min for extraction time. There were no statistically significant differences (p > 0.05) between water extracts at optimized conditions and classical methanol extracts. Total phenolic content by HPLC was192.0 mg/g of pomegranate peels on dry matter basis. Phenolics of pomegranate peels showed α-glucosidase inhibition activity with an IC50 (concentration of phenolics required to inhibit 50 % of the enzyme activity) value of 5.56 ± 2.23 µg/ml. Pomegranate peel phenolics with its antioxidant and α-glucosidase inhibition properties might be a suitable ingredient for functional food applications.

Physicochemical, bioactive, and sensory properties of persimmon-based ice cream: technique for order preference by similarity to ideal solution to determine optimum concentration.

In the present study, persimmon puree was incorporated into the ice cream mix at different concentrations (8, 16, 24, 32, and 40%) and some physicochemical (dry matter, ash, protein, pH, sugar, fat, mineral, color, and viscosity), textural (hardness, stickiness, and work of penetration), bioactive (antiradical activity and total phenolic content), and sensory properties of samples were investigated. The technique for order preference by similarity to ideal solution approach was used for the determination of optimum persimmon puree concentration based on the sensory and bioactive characteristics of final products. Increase in persimmon puree resulted in a decrease in the dry matter, ash, fat, protein contents, and viscosity of ice cream mix. Glucose, fructose, sucrose, and lactose were determined to be major sugars in the ice cream samples including persimmon and increase in persimmon puree concentration increased the fructose and glucose content. Better melting properties and textural characteristics were observed for the samples with the addition of persimmon. Magnesium, K, and Ca were determined to be major minerals in the samples and only K concentration increased with the increase in persimmon content. Bioactive properties of ice cream samples improved and, in general, acetone-water extracts showed higher bioactivity compared with ones obtained using methanol-water extracts. The technique for order preference by similarity to ideal solution approach showed that the most preferred sample was the ice cream containing 24% persimmon puree.

The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis.

BACKGROUND/AIM: Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system (CNS) disease. Among the paraclinical tests, brain and spinal Magnetic Resonance Imaging (MRI) is primarily involved in the diagnosis process, and cerebrospinal fluid (CSF) analysis is fundamental in diagnosing MS and the differential diagnosis. A positive relationship was demonstrated between oligoclonal band (OCB) positivity, CSF band number and immunoglobulin G(IgG) index. The study aimed to evaluate whether the number of OCB can predict disease activity and determine a correlation with the IgG index. METHODS: Our study included 401 MS patients who had relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinic isolated syndrome (CIS), radiologic isolated syndrome (RIS), Neuromyelitis optica spectrum disorder (NMOSD) and Acute disseminated encephalomyelitis (ADEM) with OCB number groups of 2-4, 4-8, 8-12, and 12 and above. RESULTS: No significant correlation was observed between IgG index, pre-and post-treatment EDSS (Expanded Disability Status Scale Scores) and disease-modifying therapies (DMT). Drug response was better in the patient group with band number between 2 and 8 and post-treatment EDSS scores were lower (1.62±0.44). CONCLUSION: The study results suggested that band number may be as valuable as the IgG index and a predictive biomarker for disease activity.

Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein

Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayis University's Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.

Microwave drying of quince coated with seed gum and pectin: A Taguchi optimization, techno-functional properties, and aromatic compounds.

In this study, the effects of coating quince slices with CaCl2 and pectin (C + P) followed by drying with microwave (MWD-C + P) or with hot air (HAD-C + P) were investigated to determine the physicochemical, techno-functional, textural, and volatile components of dried quince slices. A Taguchi orthogonal experimental design was set up with 18 points (L18 ), and the best conditions for drying were obtained using signal/noise ratio method. Coating quince slices with C + P and then drying with microwave at 450 W displayed the higher results compared to other points in terms of color, total phenolic, antioxidant activity, antimicrobial activity, and water holding capacity. MWD-C + P application dramatically changed the textural properties of dried quince slices in terms of hardness, gumminess, and chewiness. Moreover, MWD, lasted 12-15 min, was superior to HAD in the context of drying time. Ultrasonication as a pretreatment had no positive impact on dried products. GC-MS analyses revealed that MWD-C + P had positive effects on dried quince slices in terms of ethyl hexanoate and octanoic acid. However, MWD-C + P application triggered the formation of furfural in dried products.

Optimization of spray drying conditions for improved physical properties in the production of enzyme-modified cheese powder.

Enzyme-modified cheese (EMC), a cheese flavor additive with high-fat content, is preferably produced in powder form because of its long shelf-life and high industrial applicability. The physical properties of additives, especially with high-fat contents, are very important for their industrial usage, and the spray drying process conditions substantially determine the physical properties of powders. In this study, optimization of the spray drying process during the production of EMC powder was performed to improve the powder physical properties. The process factors were inlet temperature, feed flow rate, and aspiration rate, while the responses were selected as drying yield, Carr index (CI), wettability, surface fat content, and browning index (BI). The optimum spray drying conditions were calculated as 150°C, 9.1 mL/min, and 28.4 m3 /h for inlet temperature, feed flow rate, and aspiration rate, respectively. It has been determined that the spray drying conditions at low inlet temperature, medium feed flow, and aspiration rates in order to obtain improved powder physical properties should be preferred. Practical Application: Enzyme-modified cheese (EMC) is a widely used product in the development of foods with cheese flavor, and EMC in powder form offers various advantages for industrial applications such as ease in storage and transportation, long shelf-life, and product applicability, which mainly depend on powder physical properties. In powder production, spray drying is the principle process determining the powder physical properties, and optimization is essential for the desired physical properties. In this study, laboratory-scale optimization of EMC powder production was carried out, data was provided for scale-up studies, and the effects of processing conditions on powder physical properties were evaluated.

Changes in serum total protein and immunoglobulin G concentrations and Brix percentages in neonatal Arabian foals from birth up to 21 days of age.

The aim of this study was to evaluate changes in the serum immunoglobulin G (IgG) and serum total protein (STP) concentrations and serum Brix percentages of neonatal Arabian foals during first 3 weeks of life. Blood samples were collected from 12 apparently healthy foals by jugular venipuncture at birth and at 12-hours, 24-hours, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15 and 21 days of age. Serum IgG and STP concentrations and Brix percentages were measured by the radial immunodiffusion assay, and digital STP and Brix refractometers, respectively. Based on the serum IgG concentrations measured at 24 h, two foals were diagnosed with failure of transfer of passive immunity (FTPI). While IgG concentrations were determined using the data of foals with adequate transfer of passive immunity, other calculations were made using the data of all foals. The mean IgG concentration of the foals increased from birth (<200 mg/dl) to 12 (2068.5 mg/dl) and 24 h (2184.7 mg/dl), and progressively decreased up to 21 days of age (1318.5 mg/dl). The serum IgG concentrations at 12 h were highly correlated with each of the IgG concentrations measured over the 21-day period. The serum IgG and STP concentrations and Brix percentages of the foals diagnosed with FTPI at 12 h did not reach the adequate strata over time. These results suggest that foals can be reliably tested for passive immunity status at 12 h after birth.

Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment.

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient.

Erratum: Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment.

[This corrects the article on p. 23 in vol. 60, PMID: 36911568.].

Quality assessment of chukar partridge (A. chukar) eggs during different conditions (time, turning and position) of storage.

The present study was conducted with the aim of investigating the effect of storage length, turning frequency and egg position on internal quality traits of chukar eggs obtained from 56-week-old chukar partridges under the same nutrition and management conditions. A total of 720 eggs were collected and assigned to 36 subgroups according to storage length (7, 14, 21, and 28 d), turning frequency (0, 1, and 24 per day) and egg position (pointed end up, blunt end up and horizontal). As a result of the study, almost all the internal quality traits of chukar eggs were negatively affected by lengthening of storage period especially 21 days and longer (p < 0.001). Internal egg quality traits weren't statistically affected by turning frequency except yolk index (p < 0.01). An improvement was observed in Haugh unit, albumen index and heigh of eggs stored with pointed end up (p < 0.001). Some significant interactions occurred among all internal egg quality traits which were mostly dependent on the eggs stored horizontally, extended storage time more than 21 days and egg turning during storage. The results and interactions showed that internal quality traits would be preserved well for the eggs stored less than 21 days with the position of pointed end up independent of turning. If the storage period was to exceed 21 days, the eggs should be positioned horizontally and turning should be applied to preserve the quality of chukar eggs.

Evaluation of refractometry methods for estimating passive immunity status in neonatal foals.

The objective of this cross-sectional study was to determine the accuracy of the digital Brix and serum total protein (TP) refractometers for estimating different passive immunity status in neonatal foals. In total, 18- to 40-h old purebred Arabian foals (n = 185) were used. Serum TP concentrations, total solid percentages and IgG concentrations were measured with a digital serum TP refractometer, digital Brix refractometer and the gold standard radial immunodiffusion (RID) assay, respectively. Correlation coefficients were calculated between the refractometer and RID assay results. A receiver operating characteristic analysis was used to select the optimal cut-offs for both refractometers. Test performance and agreement were evaluated using diagnostic test characteristics at optimal thresholds and areas under the ROC curve, and by calculating Cohen's kappa coefficient. The sensitivity and specificity of the digital Brix refractometer at optimal cut-offs (≤7.8%, ≤7.9%, ≤8.2%, ≤8.3%, ≤9.0%) were 100 and 69.3%; 100% and 68.5%; 70.5% and 71.0%; 88.3% and 85.5%; 88.1% and 76% to estimate RID-IgG of <400 mg/dL, <800 mg/dL, <1500 mg/dL, <2500 mg/dL and < 3000 mg/dL, respectively. The sensitivity and specificity of the digital serum TP refractometer at optimal cut-off (≤4.6 g/dL, ≤4.6 g/dL, ≤4.8 g/dL, ≤5.0 g/dL, ≤5.4 g/dL) were 100 and 69.3%; 100% and 72.8%; 90% and 72.8%; 72.9% and 83.9%; 84.4% and 88% to estimate RID-IgG of <400 mg/dL, <800 mg/dL, <1500 mg/dL, <2500 mg/dL and < 3000 mg/dL, respectively. In conclusion, the refractometers showed a good potential as screening tools for the estimation of different IgG concentrations in neonatal foals.

Conduction in ulnar nerve bundles that innervate the proximal and distal muscles: a clinical trial.

BACKGROUND: This study aims to investigate and compare the conduction parameters of nerve bundles in the ulnar nerve that innervates the forearm muscles and hand muscles; routine electromyography study merely evaluates the nerve segment of distal (hand) muscles. METHODS: An electrophysiological evaluation, consisting of velocities, amplitudes, and durations of ulnar nerve bundles to 2 forearm muscles and the hypothenar muscles was performed on the same humeral segment. RESULTS: The velocities and durations of the compound muscle action potential (CMAP) of the ulnar nerve bundle to the proximal muscles were greater than to distal muscles, but the amplitudes were smaller. CONCLUSIONS: Bundles in the ulnar nerve of proximal muscles have larger neuronal bodies and thicker nerve fibers than those in the same nerve in distal muscles, and their conduction velocities are higher. The CMAPs of proximal muscles also have smaller amplitudes and greater durations. These findings can be attributed to the desynchronization that is caused by a wider range of distribution in nerve fiber diameters.Conduction parameters of nerve fibers with different diameters in the same peripheral nerve can be estimated.

Peripheral neuropathy in chronic obstructive pulmonary disease.

The aim of this study was to evaluate the frequency and characteristics of peripheral nervous system involvement in chronic obstructive pulmonary disease and its relation with proinflammatory cytokines such as TNF-alpha, IL-6, IGF-1 and CRP. Forty chronic obstructive pulmonary disease patients with a mean age 62.8 +/- 5.5 years and 33 healthy controls with a mean age of 61.8 +/- 7.4 were included into this study. All subjects were evaluated with standard motor and sensory nerve conduction studies. Serum TNF-alpha, IL-6, CRP and IGF-1 were measured. The muscle strengths of three muscle groups (knee extensors, shoulder abductors and flexors) were assessed with a hand-held dynamometer. Peripheral neuropathy was detected at 15% of chronic obstructive pulmonary disease patients. Ulnar motor and sensory nerves, left sural nerve distal latencies were found significantly prolonged than healthy volunteers (p = 0.011), peroneal nerve conduction velocities was found lower in patients than in healthy controls (p = 0.021), tibial nerve amplitudes was found lower in patients than healthy controls (p = 0.046). CRP and TNF-alpha were found significantly higher in chronic obstructive pulmonary disease patients and IGF-1 was found significantly lower in chronic obstructive pulmonary disease patients. There was no correlations between proinflammatory cytokines, CRP and electrophysiological findings. Left sural nerve's sensory nerve action potential amplitude was correlated positively with FEV(1)% (r = 0.425; p = 0.009). Muscle strength at the shoulder and knee were significantly reduced in patients with COPD when compared with controls. The frequency of neuropathy was higher in chronic obstructive pulmonary disease when compared with the healthy controls. Chronic obstructive pulmonary disease patients have subclinical peripheral nerve involvements.

Evaluation of upper endoscopic findings in patients with restless legs syndrome and gastric complaints.

BACKGROUND: The effect of gastrointestinal system disorders on Restless Legs Syndrome/Willis-Ekbom disease (RLS/WED) has been previously demonstrated by using serological tests. However, this association has not been supported by histopathological studies so far. OBJECTIVE: To investigate the relationship between RLS/WED, upper endoscopic imaging and histopathological results in patients diagnosed with RLS who underwent endoscopy because of gastrointestinal system (GIS) complaints. METHODS: Case-control study, including 100 patients diagnosed with RLS who presented dyspeptic complaints and underwent upper GIS endoscopy and 106 age- and sex-matched controls. RLS diagnosis was evaluated according to the four main diagnostic criteria determined by the International RLS Study Group. All patients underwent upper GIS endoscopic intervention and at least one gastric and/or antral biopsy. RESULTS: There was no significant difference between patients and controls in relation to endoscopically seen gastric ulcer, duodenal ulcer, gastroesophageal reflux disease (GERD) findings and Helicobacter pylori (HP) positivity (p>0.05). Intestinal metaplasia and mucosal atrophy were more common in RLS/WED patients compared to controls (p=0.026 and p=0.017, respectively). Additionally, ferritin levels were found to be lower than the reference value. CONCLUSIONS: The detection of increased severity of intestinal metaplasia, mucosal atrophy, and gastric inflammation in RLS/WED patients with dyspeptic complaints may entail the close gastrointestinal system evaluation of these patients. However, larger randomized and controlled trials are required on this subject where patients are evaluated by upper GIS endoscopic biopsy.