Radiological findings and their relationship with mortality in acute pulmonary embolism.

OBJECTIVE: The aim of the study was to investigate whether sarcopenia had the potential to predict mortality by analyzing epicardial and visceral fat thickness measurements, which are among the radiological findings and scores known to be crucial in determining the prognosis and risk classification of patients diagnosed with acute pulmonary embolism (PE) in the emergency department. PATIENTS AND METHODS: The study included patients diagnosed with acute PE in the emergency department from January 2019 to December 2022 and involved the retrospective examination of their demographic characteristics, clinical parameters, and radiological data obtained from computed tomography pulmonary angiography (CTPA) [main pulmonary artery (MPA) diameter, pulmonary artery obstruction, right and left ventricular diameters, epicardial and visceral tissue thicknesses, and pectoralis muscle thickness (PMT)]. The primary endpoint was mortality during the hospitalized treatment and follow-up processes, and the secondary endpoint was mortality within 90 days after diagnosis. RESULTS: Of the 389 patients included in the study, 11.6% had a fatal outcome in the early period following hospitalization for treatment, and 22.6% had a fatal outcome within the 90-day (late) period after diagnosis. In patients with late-period mortality, pleural fluid (30.8%), pericardial fluid (16.7%), and atelectasis (32.6%) were found to be statistically significantly higher. Among the markers obtained from imaging examinations, only PMT - right: 9.4 [interquartile range (IQR): 6.0-14.0]; left: 9.1 (IQR: 5.4-13.8) - was associated with mortality. According to logistic regression analysis, the MPA diameter was associated with early-period mortality, and it was determined that the right ventricular diameter and the right and left PMT values had a predictive effect on late-period mortality. CONCLUSIONS: To predict mortality, CTPA-based scoring systems that include markers such as PMT, pericardial and pleural fluid, and atelectasis would be more effective; however, large-scale studies are needed to enrich these findings.

Optimizing maintenance therapy in responders to abrocitinib induction: A post hoc analysis of JADE REGIMEN.

BACKGROUND: Treatment optimization may require dosing flexibility. The Phase 3 JADE REGIMEN trial (NCT03627767) evaluated maintenance of abrocitinib 200 mg-induced response in patients with moderate-to-severe atopic dermatitis (AD) randomly assigned to subsequent maintenance with continuous-dose abrocitinib (200 mg), reduced-dose abrocitinib (100 mg) or placebo. Maintenance with continuous-dose abrocitinib was associated with a stronger prevention of disease flares, but also with a higher occurrence of adverse events, compared with the reduced dose. OBJECTIVE: This post hoc analysis of JADE REGIMEN aimed to identify predictors of not flaring during the maintenance period and to generate tools that can be used to assess probability of not flaring. METHODS: Data were analysed from patients who responded to abrocitinib 200 mg induction therapy (12 weeks) and were randomly assigned to receive abrocitinib (200 mg or 100 mg) or placebo in the 40-week maintenance period. Demographic and baseline disease characteristics and level of response to induction were evaluated for association with not flaring using logistic regression. Parameters with a significant (p < 0.15) interaction with the treatment arm were fitted into a multivariable regression model, which was used to assess probability of not flaring. RESULTS: Lower percentage body surface area affected at baseline (p = 0.09), absence of prior exposure to systemic agents (p = 0.02) and greater percentage change in EASI from baseline to randomization (p < 0.001) were identified as predictors of not flaring with abrocitinib. In both abrocitinib arms, percentage change in EASI from baseline to end of induction (Week 12) was the major contributor to the probability of not flaring in the maintenance period. CONCLUSIONS: Maintenance of response using reduced-dose abrocitinib 100 mg may be feasible for patients with lower baseline disease severity and strong response to abrocitinib 200 mg induction treatment.

Oxidative stress may be a contributing factor in fibromyalgia patients' pain mechanisms.

OBJECTIVE: The pathophysiology of fibromyalgia (FM), a continuously painful syndrome with no known origin, has been related to mitochondrial dysfunction, oxidative stress, and inflammation. Recent studies have shown that FM may be associated with an oxidative balance disorder. The objective of this study was to measure the levels of oxidative stress in FM patients and try to understand the association between FM and free radicals. METHODS: This study was performed on 100 volunteers admitted to the University of Health Sciences, Sultan 2, Abdulhamid Han Health Application and Research Center Physical Therapy and Rehabilitation Clinic, including 50 healthy controls and 50 patients with FM. To analyze oxidative stress biomarkers, total oxidant status (TOS) and total antioxidant status (TAS) levels were measured. Total thiol (TT) and native thiol (NT) concentrations were measured to determine the relationship between thiol groups. Disulfide (DIS) and oxidative stress index (OSI) were calculated with mathematical formulas. RESULTS: While TOS and OSI levels were statistically higher in FM patients, TAS levels were significantly lower compared to the healthy control group (p<0.001). In comparison to the healthy control group, FM patients had considerably decreased TT and NT levels. DIS levels were significantly higher in FM patients than in controls (p<0.001). CONCLUSIONS: Reactive oxygen species have several negative impacts on the human body. As a result of the measurements we analyzed, the relationship between FM and oxidative stress should be studied in terms of disease progression and may help improve the treatment process.

Determination of the cryoprotective effect of n-methylacetamide in rabbit semen.

BACKGROUND: Amides are low molecular weight cryoprotectants. N-methylacetamide (MA) is one of the cryoprotectant agents in this group. OBJECTIVE: To investigate the cryoprotective effect of MA in rabbit semen. MATERIALS AND METHODS: For this purpose, six ejaculates from six New Zealand rabbits were collected and pooled using an artificial vagina. Pooled semen was divided into four equal parts and diluted with TCG+ egg yolk. CPA was added to form the following groups: Control with 6% DMSO; Group 1 with 1% MA; Group 2 with 2% MA; and Group 3 with 3% MA. After the addition of CPA, the semen eqilibration procedure was started. Sperm were then drawn into 0.25 mL straws, frozen by automatic semen freezing and stored in a liquid nitrogen container. Pipettes were thawed after 24 h and analyses were performed. RESULTS: Total, progressive and rapid motility values of the Control group were higher than those of the MA groups (p<0.05). However, there was no statistical difference between the Control and Group 2 in terms of these parameters. While there was no statistical difference between the groups in terms of acrosome damage and mitochondrial membrane potential, the best results were observed in Control, Group 2, Group 1 and Group 3, respectively. When we compared all groups, no difference was found in terms of MDA, CAT and GSH-Px. There was a statistical difference between Group 3 and the Control in terms of GSH level (p<0.05). CONCLUSION: DMSO appeared to be more useful for the cryopreservation of rabbit semen compared to MA. Doi.org/10.54680/fr23610110812.

The prophylactic efficacy of Anatolian propolis in individuals at high risk of COVID-19.

OBJECTIVE: No prophylactic treatment is available for individuals at high risk of developing COVID-19. This study, which was conducted between December 25, 2020, and January 25, 2021, is one of the first clinical studies to evaluate the efficacy of Anatolian propolis supplement against COVID-19. The aim was to obtain evidence on the prophylactic use of Anatolian propolis in individuals at high risk of developing COVID-19. SUBJECTS AND METHODS: This volunteer-based study was conducted in two centers. The study involved 209 healthcare professionals (physicians, nurses, medical secretaries) from Emergency Medicine Department of Medical Faculty of Ataturk University and Emergency Medicine Department of Rize Recep Tayyip Erdogan University. 204 participants meeting the study criteria were divided into two groups as experimental group and control group. The experimental group received 20 drops of BEE'O UP (BEE&YOU) 30% Propolis drops twice a day during a follow-up period of 1 month. The control group received no supplement but was followed up. The participants showing symptoms during the study and all the participants at the end the study were subjected to PCR testing. RESULTS: The evaluation of the results of PCR testing at the end of the study has shown that 14 participants from the control group and only 2 participants from the experimental group, who received Anatolian propolis supplement, were reported as positive cases. CONCLUSIONS: It has been found that a statistically significant protection was induced against COVID-19 infection in 98% of the experimental group, who received Anatolian propolis, compared to the control group.

Dexpanthenol and ascorbic acid ameliorate colistin-induced nephrotoxicity in rats.

OBJECTIVE: Colistin is a potent antibiotic which is mainly preferred in the treatment of multidrug-resistant (MDR) gram-negative bacilli. However, due to the increased risk of acute kidney injury following its use, the clinical application is limited. This nephrotoxicity is known to be induced by oxidative stress and related inflammation. In this study on rats, potent antioxidants Dexpanthenol (DEX) and Ascorbic acid (Vit C) have been administered in combination with Colistin to find out whether they would weaken Colistin's nephrotoxic effects. MATERIALS AND METHODS: Inflammation biomarkers were studied with enzyme-linked immunosorbent assay (ELISA) kits, and oxidative stress biomarkers were studied with different photometric methods in blood and tissue samples taken after treatment with DEX and Vit C in rats with colistin nephrotoxicity. In addition, inflammation and necrosis in the kidney tissues were examined pathologically. RESULTS: It has been observed in the serum and tissue samples that DEX and Vit C decrease oxidative stress and inflammation biomarkers, therefore acting as nephroprotective agents. CONCLUSIONS: These compounds have been found to ameliorate the nephrotoxic effects of Colistin, which were demonstrated in the rats treated with Colistin, as well as the combinations.

Integrase inhibitor-based antiretroviral treatments decrease oxidative stress caused by HIV infection.

OBJECTIVE: Several chronic illnesses, including HIV infection are associated with oxidative stress. In addition to HIV itself, some antiretrovirals also increase oxidative stress while decreasing viral replication. To investigate the alterations in oxidative stress parameters and thiol-disulphide homeostasis in people living with HIV who were receiving integrase inhibitor-based antiretroviral therapy. PATIENTS AND METHODS: Thirty treatment-naive adult people living with HIV were prospectively enrolled in the study. Sera were collected from patients twice: at the beginning of antiretroviral therapy (group 1) and 6 months later (group 2). Thirty age-matched healthy volunteers were enrolled in the study as the control group (group 3). Serum levels of total antioxidant status (TAS) and total oxidative status (TOS) were determined using an automated measurement method. Serum malondialdehyde (MDA) and protein carbonyl (PC) levels were measured spectrophotometrically. CD4+ T-cells were counted flow cytometrically. A mathematical equation was used to calculate the oxidative stress index (OSI) and determine disulfide levels (DIS). RESULTS: TOS, OSI, MDA, and PC levels were significantly increased in treatment-naive people living with HIV than in those receiving ART (p<0.001). Total and native thiol were significantly lower in both HIV-infected groups than in the control group (p<0.001). PC and MDA levels were significantly higher in both HIV-infected groups than in the control group (p<0.001). In correlation analysis, MDA and age were negatively correlated, whereas TAS was positively correlated with CD4+ T-cell count in treatment-naive people living with HIV. Age was positively correlated with TOS (r:0.421, p:0.023) in healthy controls. CONCLUSIONS: Integrase inhibitor-based antiretroviral treatments decrease the oxidative stress caused by HIV infection and may be a good therapeutic option in people living with HIV.

Investigation of DNA damage, oxidative stress, and inflammation in synthetic cannabinoid users.

BACKGROUND: The widespread use of synthetic cannabinoids (SCs) among youth has become an important public health problem. Several life-threatening side effects of SC have been reported, including cardiovascular, gastrointestinal, neurological, renal, metabolic, ophthalmologic, and pulmonary effects, besides skin toxicity and hepatotoxicity. METHODS: Given that high levels of SC can lead to oxidative stress, DNA damage, and inflammation, it has been aimed in this study to investigate the effects of SC in aspects of primary DNA damage, plasma total oxidant status (TOS)/total antioxidant status (TAS), thiol-disulfide homeostasis, myeloperoxidase (MPO) level, and cytokine levels (interleukin 1 beta (IL-1ß), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α)) of 40 SC users (SCUs) in Turkey. RESULTS: Mean plasma TOS levels were significantly higher in the SCUs group than in the healthy group (HG). Similarly, mononuclear leukocyte DNA damage, plasma TOS, MPO activity, disulfide, oxidative stress index levels, IL-1ß, IL-6, and TNF-α levels were significantly higher in the SCU group than in the HG, whereas plasma TAS, total, and native thiol levels were significantly lower in the SCU group than in the HG. CONCLUSION: It is concluded that SC can cause increase in oxidative stress and in inflammatory processes in addition to its potential for DNA damage. Additional studies with larger sample sizes and longer durations should be held to understand more specific outcomes of SC use.

Clinical and imaging features in adult patients with bone marrow haemophagocytosis with and without haemophagocytic lymphohistiocytosis: a single-institution experience.

AIM: To evaluate clinical, laboratory, imaging findings, and outcomes of adult patients with bone marrow haemophagocytosis (BMH) who meet the diagnostic criteria for haemophagocytic lymphohistiocytosis (HLH) with those who do not meet the criteria. MATERIALS AND METHODS: A pathology database search was performed from 2009 to 2019 to identify adult patients with BMH. Electronic medical records of 41 patients were reviewed to distinguish those who fulfil the HLH-2004 diagnostic guidelines, which identified 22 patients (11 men; mean age, 53.5 years) who met the criteria (HLH+) and 19 patients (13 men; mean age, 54.7 years) who did not meet the criteria (HLH-). Multi-modality imaging was reviewed to record imaging features. Clinical, laboratory, imaging findings, and outcomes were compared between the two groups using Fisher's exact test and Wilcoxon test. RESULTS: Malignancy (non-Hodgkin's lymphoma) was the major trigger for both groups. 86% of HLH+ and 31% of HLH- patients presented with fever. Compared to the HLH- group, the HLH+ group exhibited higher serum ferritin, triglycerides, and lower fibrinogen levels (p<0.05). Alveolar opacities and hepatosplenomegaly were the most common imaging findings identified in both groups. Median overall survival of HLH+ and HLH- were 123.5 (interquartile range [IQR]: 40.7-681.7 days) and 189 days (IQR: 52-1680 days), respectively. Distribution of imaging features and overall survival did not differ between the groups. CONCLUSION: Malignancy is the major trigger for BMH in both HLH+ and HLH- groups. HLH+ and HLH- groups have similar imaging manifestations or clinical outcomes. Therefore, presence of BMH alone is correlated with high morbidity and mortality.

Gene Expression Profiling in Breast Cancer and Its Effect on Therapy Selection in Early-Stage Breast Cancer.

Breast cancer is a heterogeneous disease. The purpose of adjuvant therapy for early-stage breast cancer is to provide maximum benefit with minimum side effects and not to under-treat or over-treat. The clinical progresses of patients with the same clinical and pathological characteristics who are given similar treatments may show major differences. This fact indicates that the prognostic and predictive factors that we have used until recent years for therapy selection are not really sufficient, we need new markers, every disease and every individual are unique and that treatment should be individualized. The gene expression profiling, which has come into clinical use in recent years, is beneficial in therapy selection for luminal breast cancer cases. A differentiation can be made among patients for whom only endocrine treatment would be adequate and those who should also receive chemotherapy in addition to endocrine treatment. Several new gene expression analysis studies targeted at gaining the ability to determine drug selection in chemotherapy, endocrine treatment and neo-adjuvant therapy are also currently ongoing. The staging system for new breast cancer that is to be published in the year 2018 also includes gene expression analyses within the prognostic panel and the stage changes depending on the result. The statement 'Treat the patient, not the disease.' is becoming increasingly entrenched in our clinical practice. This article briefly summarizes the gene expression profiles, which are validated and used in the selection of therapy for early-stage breast cancer.

Serum obestatin and omentin levels in patients with diabetic nephropathy.

INTRODUCTION: Diabetic nephropathy is the leading cause of chronic kidney disease and accounts for almost 45% of all new patients requiring renal replacement therapy. Omentin and obestatin, two novel proteins were suggested to be associated with insulin resistance, type 2 diabetes and cardiovascular risk factors. Thus, we postulated that they may also have an association with diabetic nephropathy which is known to be an independent cardiovascular risk factor. In order to investigate such an association we compared serum omentin and obestatin levels in type 2 diabetic patients with normoalbuminuria (NA) and macroalbuminuria (MA). MATERIALS AND METHODS: A total of 81 type 2 diabetic patients were separated into two groups according to their proteinuria status; patients with NA (n = 39) and patients with MA (n = 42). Two groups were compared in terms of serum omentin and obestatin levels. RESULTS: While s erum omentin levels did not differ among two groups (P = 0.407), serum obestatin levels were significantly higher in MA group (P = 0.001). CONCLUSION: The results of this study showed that higher serum levels of obestatin were associated with macro albuminuria suggesting that obestatin may have a role in underlying pathogenic mechanisms that leads to diabetic nephropathy.

Evaluation of the Relation between Vitamin D and Serum Omentin and Vaspin Levels in Women.

INTRODUCTION: Vitamin D deficiency is a common health problem seen worldwide. Adipokines released from adipose tissue play important roles in the control of appetite and satiety, modulation of body fat distribution, regulation of insulin sensitivity and secretion, control of blood pressure, and regulation of endothelial functions and inflammation. The aim of the present study is to investigate how vitamin D levels affect serum vaspin and omentin levels. MATERIALS AND METHODS: This is a cross-sectional study design. A total of 77 female volunteers were included in the study, and they were divided into 3 groups according to vitamin D levels. Relation of vitamin D with serum vaspin and omentin levels was determined in these groups. RESULTS: Serum omentin, vaspin and parathyroid hormone (PTH) levels differed significantly between the groups (p<0.001, p<0.001, p=0.001, respectively). Omentin levels correlated significantly and negatively with the vitamin D and vaspin levels, but there was a significant positive correlation between omentin and PTH (r=-0.626, p<0.001; r=-0.867, p<0.001; r=0.461, P<0.001, respectively). A significant positive correlation was detected between vaspin levels and vitamin D, whereas omentin and PTH levels correlated negatively and significantly (r=0.374, p<0.001; r=-0.867, p<0.001; r=-0.374, p=0.002, respectively). CONCLUSIONS: Vitamin D may affect the release of adipokines from the adipose tissue, and this effect may be in a negative or positive manner. This effect of vitamin D may probably be mediated via vitamin D receptors exhibited in the adipose tissue, or via mechanisms not identified yet. The results of this study suggested that there was a significant, positive correlation between serum vitamin D levels and vaspin, whereas a significant, negative correlation between vitamin D levels and omentin. Further studies on larger series are needed in order to confirm these results.

Evaluation of ocular pulse amplitude and choroidal thickness in diabetic macular edema.

PURPOSE: The aim of this study is to evaluate the ocular pulse amplitude (OPA) and choroidal thickness (CT) measurements in patients with diabetic macular edema (DME) and healthy subjects. METHODS: A total of 34 patients (12 male and 22 female) who had type 2 diabetes mellitus with DME and 34 sex-matched healthy subjects (13 male and 21 female) were included in this prospective study. The intraocular pressure (IOP) and OPA were measured with Dynamic contour tonometer (Pascal DCT, Switzerland). The subfoveal CT was measured using the Cirrus HD-OCT (Carl Zeiss Meditec). The CT at 1500 µm and 3000 µm nasal and temporal to the central fovea was also measured. RESULTS: The mean IOP values were 18.4±3.5 and 17.1±2.1 mm Hg in DME patients and healthy controls, respectively (P= 0.091). The mean OPA values in patients with DME (2.58±0.96) and controls (3.52±1.03) were statistically different (P<0.001). The mean subfoveal CT value was 273.5±30.2 µm in the eyes with DME and 321.4±36.5 µm in the control group (P< 0.001). In both groups, linear regression analysis showed no significant association between OPA and CT measurements. The IOP showed a significantly positive correlation with OPA in both DME (P=0.002, r=0.526) and controls (P=0.004, r=0.483). CONCLUSIONS: The current study suggests that both pulsatile choroidal blood flow and CT are decreased in patients with DME.

Evaluation of adiponectin and lipoprotein(a) levels in cardiac syndrome X.

AIMS: Low adiponectin and high lipoprotein(a) [Lp(a)] levels are associated with endothelial dysfunction, atherosclerosis, and coronary artery disease. Cardiac syndrome X (CSX) is characterized by anginal symptoms, positive stress test, and documentation of normal epicardial coronary arteries with angiography. In this study we aimed to investigate the relationship between CSX and circulating levels of adiponectin and Lp(a). PATIENTS AND METHODS: We enrolled 53 female patients with CSX and 33 patients as the control group. The diagnosis of CSX was made according to presence of angina, findings suggestive of ischemia during stress electrocardiography or myocardial perfusion scintigraphy, and documentation of normal coronary arteries in coronary angiography. The control group consisted of patients with atypical angina and normal stress electrocardiography test results. Both groups were matched in terms of hypertension, diabetes mellitus, and metabolic syndrome. RESULTS: Adiponectin levels were significantly decreased in patients with CSX (4.57 µg/ml vs. 13.18 µg/ml; p=0.001); however, Lp(a) levels were significantly increased (36.30 mg/dl vs. 7.24 mg/dl; p < 0.001). Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) concentrations did not differ between the case group and the control group (p=0.14, p=0.62, p=0.64, respectively). There was no significant difference between groups in terms of age, body mass index, waist circumference hypertension, hyperlipidemia, diabetes mellitus, or metabolic syndrome. In multivariate analysis, Lp(a) and adiponectin were found to be independent predictors of CSX. An Lp(a) level of > 21 mg/dl had 84 % sensitivity and 96 % specificity {area under the curve (AUC)= 0.922, p < 0.0001, 95 % CI [0.842-0.970]} and an adiponectin level of ≤ 5.18 µg/ml also had 58.7 % sensitivity and 82.1 % specificity (AUC=0.726, p=0.0003, 95 % CI [0.609-0.823]) for detecting CSX. CONCLUSION: We detected low adiponectin and high Lp(a) levels in patients with CSX and these findings may be related to the microvascular injury in CSX.

Impact of valve surgery on serum osteopontin levels in patients with mitral regurgitation.

OBJECTIVE: Osteopontin (OPN), a sialoprotein present within atherosclerotic lesions, especially in calcified plaques, is linked to the progression of coronary artery disease and heart failure. We assessed the impact of valve surgery on serum OPN and left ventricular (LV) function in patients with mitral regurgitation (MR). METHODS: Thirty-two patients with severe MR scheduled for surgery were included in the study. Echocardiography markers were assessed preoperatively and at 3 months following the surgery and matched with the serum OPN levels. RESULTS: Valve surgery was associated with a reduction of the ejection fraction (EF) from 55.2 ± 6.3 to 48.8 ± 7.1% after surgery, p < 0.001. Following surgery, the OPN level was significantly higher than preoperatively (mean 245, range 36-2,284 ng/ml vs. 76, 6-486 ng/ml, p = 0.007). Preoperative OPN exhibited a slight negative correlation with the EF (r = -0.35, p = 0.04), and a moderate correlation with vena contracta (r = -0.38, p = 0.02). There were no other meaningful correlations between conventional echocardiographic parameters and OPN. CONCLUSION: Following valve surgery due to severe MR, patients exhibited a decrease in EF and an increase in OPN levels. The assessment of preoperative OPN failed to strongly predict probable LV dysfunction.

Hallermann-Streiff syndrome with hemihypertrophy.

We report on a five year old girl with Hallermann-Streiff syndrome and hemihypertrophy. Hemihypertrophy does not appear to have ever been associated with Hallermann-Streiff syndrome.

Aspects of thermal martensite in a FeNiMnCo alloy.

Thermal martensite characteristics in Fe-29%Ni-2%Mn-2%Co alloy were investigated with scanning electron microscopy (SEM) and Mössbauer spectroscopy characterization techniques. SEM observations obviously revealed the lath martensite morphology in the prior austenite phase of examined alloy. As well, the martensitic transformation kinetics was found to be as athermal type. On the other hand, Mössbauer spectroscopy offered the paramagnetic austenite phase and ferromagnetic martensite phase with their volume fractions. Also, the internal magnetic field of the martensite was measured as 32.9T from the Mössbauer spectrometer.

Encephalitis in a child during atypical course of rubella.

Rubella is usually encountered as a mild viral illness in children and complications are not common. We reported rubella encephalitis in the atypical course of rubella without rash in a 9-year-old boy. He was admitted with a headache, fever, loss of consciousness and bilateral retroauricular lymphadenopathy. The cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis, increased protein levels and a normal glucose value. Immunoglobulin (Ig) M antibodies against rubella virus were positive in CSF and serum. IgG antibody also became positive in his serum 3 weeks after his admittance. We emphasized that rubella may appear without any rash and cause encephalitis. In unvaccinated children, rubella should be considered in the differential diagnosis of encephalitis.

Hepatitis A seroprevalence and its relationship with environmental factors in children of different age groups in Kahramanmaras, Eastern Mediterranean region of Turkey.

Hepatitis A infections are influenced by environmental and socioeconomic factors. Epidemiologic studies regarding hepatitis A virus (HAV) infection in Turkey have not previously examined these factors. We investigated HAV seroprevalence and its association with sociodemographic factors among children of various ages in the Eastern Mediterranean region of Turkey. The study included 1142 children (603 male and 539 female) between ages of 6 months and 18 years. Seropositivity in the whole group was 57.2%. HAV prevalence rates according to age groups were as follows: 35.5% in 6-23 months group, 19.2% in 2-5 years group, 74.3% in 6-10 years group, 83.0% in 11-14 years group, 92.8% in 15-18 years group. Risk factors that influenced seropositivity were; dense population, over-crowded families, excessive number of siblings, low socioeconomic status and low education of the mother. As HAV seroprevalence in children older than 6 years of age is high, we recommend hepatitis A vaccination in this region after the first year of life.

Influence of the relapse and remission periods on hearing status in children with minimal change nephrotic syndrome.

OBJECTIVE: Minimal change nephrotic syndrome (MCNS) is characterized by the onset of NS (Nephrotic Syndrome) without systemic disease, hypocomplementemia, or other serious signs of renal disease. Hearing status is not very well known in MCNS. Our objective was to address this question and to find out remission and relapse periods of the syndrome would affect the hearing of the patients. METHODS AND PATIENTS: Otologic status of 26 children with clinical MCNS was investigated in relapse and remission periods using audiometry and tympanometry. The pure tones that were obtained at the frequencies 250, 500, 1000, 2000, 4000 and 6000 Hz were noted. Pure tone averages (PTAs) were calculated at 500, 1000, 2000 and 4000 Hz frequencies. RESULTS: In both remission and relapse periods, PTA of the patients did not change and was 13 dB. The frequency specific pure tone results were not significantly different between the right and left ears of the patients as well as between the remission and relapse periods (p > 0.05). In the relapsing and remission periods, type A tympanogram was encountered in 86.4% and 92.3% of the ears, respectively. Type B tympanogram was encountered in 11.5% and 3.8% of the ears in the relapsing and remission periods, respectively. Type C tympanogram was encountered in 3.8% of the ears both in the relapsing and remission periods. Differences between the tympanometry results were not significant (p > 0.05). CONCLUSION: MCNS in childhood is not associated with an alteration in the hearing status, both in remission and relapse periods of the disease.