Instant stevia powder as a novel potential additive for enhancing nutritional value and quality characteristics of yogurt.

In the current study, yogurts containing instant stevia powder (ISP) at varying proportions (0.1, 0.2, 0.3, and 0.4 g/100 mL) were perused in terms of physicochemical attributes, textural behavior, antioxidant activity, and sensory acceptability during 14 day storage at 4 °C. For this, bioactive components extracted by using microwave-assisted system were spray dried in optimum conditions (11 mL/min flow rate and 167 °C inlet air temperature) and then incorporated into yogurts. The minimal syneresis value (17.09 g/100 g) at the day of 14 was detected in ISP (0.4 g/100 mL)-supplemented yogurts while this value was reached to 19.45 g/100 g in control counterpart without stevia powder. Enriching yogurts with powders was a plausible way for boosting their mechanical properties. The antioxidative parameters namely total phenolic content (TPC), DPPH, ABTS, FRAP, and CUPRAC values were tendency to increase with ISP increment in yogurts. Low scores in sensory evaluation were detected in yogurts loaded with ISP above a certain amount (more than 0.2 g/100 mL). Sum up, the findings proved that the hypotheses (fabricating innovative dairy product rich in bioactive substances and maintaining quality parameters of yogurts during storage) predicted for this study were successfully achieved. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05892-z.

Analysis of the Correlation of the Lamina Papyracea-to-Midline Distance with the Location of Anterior Ethmoidal Artery and Keros Classification.

The aim of the study was to investigate the relations between anatomical structures that are susceptible to inadvertent injuries during the surgery using preoperative computed tomography (CT) scans. 153 CT scans were reviewed and the distance from the lamina papyracea (LP) to the midline and the distance of the anterior ethmoidal artery (AEA) to the skull base were measured bilaterally. Also, the depth of olfactory fossa was measured and categorized using the Keros classification. The measurements were analyzed to determine whether LP-to-midline distance was correlated with the distance between the AEA and the skull base and Keros classification. Additionally, correlation of Keros classification with the distance from the AEA to the skull base was investigated. In a total of 306 measurements, 26 (%8.49) were classified as Keros type I, 200 (65.35%) as Keros type II and 80 (25.14%) as Keros type III. Statistically, LP-to-midline distances on the right and left sides were significantly associated with the distance from the AEA to the skull base on the same side (R:p < 0.001, L:p = 0.01) and the Keros classification on the same side (R:p < 0.001, L:p = 0.004). Also, a significant association was found between the Keros classification and the distance from the AEA to the skull base (R:p < 0.001, L:p = 0.02). The locations of anatomical structures are defined in relation to each other during the development of maxillofacial bones. CT scans should be examined and anatomical structures and relations among them reviewed very carefully before ESS. Otherwise, some accidental injuries may arise during the surgery while trying to avoid complications. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03931-x.

Increasing the Sensitivity of Leishmania RNA Virus 2 (LRV2) Detection with a Modification in cDNA Synthesis

Objective: Leishmania RNA virus was detected the first time in the New World Leishmania species. Recent studies were also showed the presence of Leishmania RNA virus 2 (LRV2) in Old Word Leishmania species including Turkish L. major and L. tropica isolates. This study aimed to increase the sensitivity of qPCR with a modification in the denaturation step of cDNA preparation protocol. Methods: In this study, LRV2+ three L. major, two L. tropica strains and L. major control strain (MHOM/SU/73/5-ASKH) were included. Total RNA isolation was done using different numbers of Leishmania promastigotes (108, 105 and 103). Before cDNA synthesis, samples were denatured at 95 °C for 2 min, as a modification of the kit procedure. qPCR was undertaken using 0.5 mM primers (LRV F-HR/LRV R-HR) diluted in SYBR Green Master mix. Results: We observed lower Ct values in amplicons with the modified version than with the classical kit protocol for cDNA synthesis, in all of the strains used in the study. The addition of pre-denaturation step at 95 °C showed lower Ct values meaning the sensitivity increased. Different parasite dilutions showed similar results. Conclusion: It is important to increase the sensitivity especially with the aim for detecting LRV in clinical samples obtained from patients probably have less number of parasites. The presence and burden of the virus can help to understand the relationship between the clinical findings and the pathogenicity of the parasite which may lead to changes in the course of treatment.

Analysis of the Effect of Weight Loss on Eustachian Tube Function by Transnasal Videoendoscopy.

OBJECTIVE: To investigate the effect of weight loss after bariatric surgery on eustachian tube (ET) function with video endoscopy. MATERIALS AND METHODS: The present study was conducted as a prospective cohort and was completed with 19 patients. Three-step tympanometry (basal, Toynbee, Valsalva), dynamic slow-motion video endoscopy, and the Eustachian Tube Dysfunction Questionnaire-7 (ETDA-7) were applied to the patients preoperatively before bariatric surgery and in the postoperative 6th month. Dynamic slow-motion video endoscopy was graded between 0 and 3, or classified as patulous, as indicated in the literature. RESULTS: The mean body mass index of 6 male and 13 female patients decreased from 47.3 ±â€Š4.6 to 31.2 ±â€Š5.4. Grade decline (median 2 ±â€Š1) was experienced in all patients in DSVE, and 1 patient resulted as patulous ET. The ETDA-7 scores decreased in11 patients, remained stable in 7 patients, and increased in 1 patient with patulous ET. The statistical analysis of the preoperative and postoperative DSVE grading and ETDA-7 scores, excluding the patulous ET patient, was found to be significant (P  = 0.001 and P  = 0.003, respectively). There was no significant change in any of the tympanometry parameters (P > 0.05). CONCLUSIONS: Rapid weight loss with bariatric surgery results in an improvement in both the DSVE images and in the complaints of ET dysfunction in the majority of patients, but in some patients it may result in patulous ET. Therefore, preoperative evaluation of the ET with DSVE and questioning the patient's complaints are important in predicting patients who may develop patulous ET.

Acoustic parameter changes after bariatric surgery.

OBJECTIVE: To investigate the acoustic parameter changes after weight loss in bariatric surgery patients. MATERIALS AND METHODS: This prospective, longitudinal study was conducted with 15 patients with planned bariatric surgery, who were evaluated pre-operatively and at 6 months post-operatively. Fundamental frequency (F0), Formant frequency (F1, F2, F3, and F4), Frequency perturbation (Jitter), Amplitude perturbation (Shimmer) and Noise-to-Harmonics Ratio (NHR) parameters were evaluated for /a/, /e/, /i/, /o/, and /u/ vowels. Changes in the acoustic analysis parameters for each vowel were compared. The study group was separated into two groups according to whether the Mallampati score had not changed (Group 1) or had decreased (Group 2) and changes in the formant frequencies were compared between these groups. RESULTS: A total of 15 patients with a median age of 40 ± 11 years completed the study. The median weight of the patients was 122 ± 14 kg pre-operatively and 80 ± 15 kg, post-operatively. BMI declined from 46 ± 4 to 31 ± 5 kg/m2. The Mallampati score decreased by one point in six patients and remained stable in nine. Of the acoustic voice analysis parameters of vowels, in general, fundamental frequency tended to decrease, and shimmer and jitter values tended to increase. Some of the formant frequencies were specifically affected by the weight loss and this showed statistical significance between Group 1 and Group 2. CONCLUSION: The present study reveals that some specific voice characteristics might be affected by successful weight loss after bariatric surgery.HighlightsObesity reduces the size of the pharyngeal lumen at different levels.The supralaryngeal vocal tract size and configuration is a determinative factor in the features of the voice.Changes in the length and shape of the vocal tract, or height and position of the tongue can result in changes especially in formant frequencies in acoustic analysis.

ANTIBACDUS-PAN: Antibacterial Utilization among Adult Patients Before and During COVID-19 Pandemic within 12-Months Period: A Tertiary Hospital Pharmacoepidemiology Study.

Objective: Irrational use of antibacterials is a concern during the COVID-19 pandemic. Hospital pharmacoepidemiology studies are important for evaluating the rational use of medicines, especially antibacterials, during pandemics. Defined daily doses (DDD) and drug utilization 90% (DU90%) are established methods for the evaluation of drug utilization. We aimed to evaluate antibacterial utilization in a tertiary hospital setting at Koç University Hospital (KUH). Materials and Methods: This cross-sectional, descriptive study was retrospectively conducted with data extracted from KUH Inpatient Electronic Order System (CP) and was carried out for a period of one year. Antibacterial utilization of adult (aged ≥ 18 years) inpatients, who were prescribed at least one type of systemic antibacterial (ATC code J01), was evaluated using the recommended parameter DDD/100 admission and compared between 6 months before COVID-19 and during COVID-19 periods. March 11, 2020, the very first COVID-19 diagnosed case in Turkey, was set as the cutoff date of the 6-month period for the selection of the compared antibacterials using the DU90% method. Results: Finally, 3280 of 5942 and 2605 of 4942 prescriptions for pre-COVID-19 and COVID-19 periods were included, respectively. Antibacterial utilization according to DDD/100 admissions increased from 193.96 to 201.26 DDD/100 admissions after the initiation of COVID-19 pandemic. The most utilized antibacterials were piperacillin and enzyme inhibitors in pre-COVID-19 period, whereas meropenem was utilized the most during COVID-19 period. Azithromycin utilization increased by 656.24%, whereas clarithromycin utilization decreased by 52.12%. Antibacterials were utilized most in general surgery department, with an increase of 17.57%. Conclusion: There is an increase in antibacterial utilization in KUH during COVID-19 pandemic, especially reserved antibacterials, which is a concern for antibacterial resistance.

Spirituality and Well-Being of Children, Adolescent, and Adult Students: A Scientific Mapping of the Literature.

This study aims to map the selected literature on students' spirituality and well-being to reveal the current and historical research trends in the relevant literature. Bibliographic coupling of the journals, countries, authors, and organizations, and co-occurrences of author keywords were illustrated through VOSviewer. Moreover, citation analysis was done, and h-classics publications were reviewed. The researchers did the initial search on January 5, 2020, and updated all the records on August 14, 2021. Most of the studies showed that students' spirituality was positively associated with their well-being. Most of the researchers preferred to work on samples of adult and adolescent students rather than children. The current and historical trends in the relevant literature are discussed in the paper.

Determination of sand fly fauna and molecular detection of Leishmania in sand flies in Antalya Province, Southern Turkey.

Visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL) are diseases transmitted by infected female sand flies. Since the eradication of malaria in Turkey, CL is the main vector-borne disease in the country, with more than 2000 cases per year, making it a significant public health problem. The aims of this study were to carry out an entomological survey in Antalya Province, an endemic area for CL in the Mediterranean Region of Turkey, to identify sand fly fauna and to screen female specimens for the presence of Leishmania parasites (Leishmania infantum, L. tropica, L. major, and L. donovani) using molecular analysis. Sand flies were collected in 42 localities of seven districts in Antalya Province using CDC miniature light traps in two different periods, June 2012 and September 2013. The specimens were kept in 96% ethanol until the dissection was done. The head and genitalia of the specimens were cut for preparing individual slides for species identification. The rest of the body of female specimens was kept separately. The specimens were identified at the species level, and 27 pools were generated according to the locations and species for screening the presence of Leishmania. A commercial kit was used for DNA extractions. Real-time and conventional polymerase chain reaction (PCR) targeting the internal transcribed spacer region (ITS1) were then performed. In total, 1306 specimens comprising nine species belonging to the Phlebotomus genus were collected in the study region, with Phlebotomus neglectus/syriacus (38.82%) the most abundant, followed by P. alexandri (21.67%) and P. tobbi (20.44%). In the 27 pools, Leishmania infantum DNA was detected in four pools containing P. neglectus/syriacus and one pool containing P. tobbi. In conclusion, the sand fly fauna in the Antalya Province is diverse. The probable vector sand fly species are P. neglectus/syriacus and P. tobbi with high dominance (59.26%), which indicates a high risk of CL transmission. The data presented here may help to shed more light on the transmission cycles of the Leishmania parasite in this CL endemic area.

Generation of transgene-free iPSC lines from three patients with Friedreich's ataxia (FRDA) carrying GAA triplet expansions in the first intron of FXN gene.

Friedreich's ataxia (FRDA) is a rare neurodegenerative disorder which is caused by triplet repeat expansion (GAA) in the first intron of FXN gene. In this present study, we generated induced pluripotent stem cells (iPSC) lines from fibroblasts of three unrelated FRDA patients using integration-free episomal vectors. All iPSC lines express the pluripotency markers such as OCT4 and SSEA4, display normal karyotypes and can differentiate into all three germ layers via in vivo teratoma formation assay.

The molecular and serological investigation of Feline immunodeficiency virus and Feline leukemia virus in stray cats of Western Turkey.

This study aimed to investigate the Feline immunodeficiency virus (FIV) / Feline leukemia virus (FeLV) infection prevalence among looking healthy stray cats in Western Turkey by serologic and molecular-based tests. A total of 1008 blood samples from the stray cats were used in this study. All samples were tested for FIV antibodies / proviral DNA and FeLV antibodies / antigens / proviral DNA. The genetic characterization and phylogenetic analysis of FeLV and FIV were carried out in this study. These cats also tested for Leishmaniasis and Toxoplasmosis previously. FIV Ab and proviral DNA detected in 25.2 % and 25.5 % of samples, respectively. FeLV Ab, Ag, proviral DNA positivity was in 45.2 %, in 3.3 %, in 69.7 %, respectively. The molecular detection and phylogenetic analysis of the current FeLV pol gene and FIV gag gene performed. The molecular characterization for the pol gene of FeLV (enFeLV and exFeLV) among Turkey's cat population was reported for the first time. The exFeLV pol sequences closer to the FeLV-A genotype, and the enFeLV pol sequences overlapped with other enFeLV. The current FIV gag sequences were clustered within the subtypes A, B, and C. The findings revealed FeLV subtype A and FIV subtype-A, subtype-B, subtype-C circulate among Turkish stray cats. Single and multiple co-infection positivity was found higher compared to previous reports.

Postoperative Audiometric Results of Patients with Otosclerosis in relation with High-resolution Computed Tomography and Intraoperative Macroscopic Findings.

OBJECTIVE: To analyse postoperative audiological findings in fenestral otosclerosis patients treated with stapedotomy, focal location-extensiveness findings on temporal high-resolution computed tomography (HRCT), and intraoperative macroscopic stapes footplate findings. Moreover, preoperative audiological findings were compared with HRCT and intraoperative macroscopic findings. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Turkey from January 2015 to January 2018. METHODOLOGY: Patients were classified according to the temporal bone HRCT findings into three groups based on otosclerotic focus location and extensiveness. Macroscopic classification was based on the intraoperative findings of blue and white footplate. Patients with obliterative otosclerosis were not included in the study. Preoperative and postoperative audiological findings as well as surgical success were investigated. Findings were compared with HRCT and macroscopic classification groups. RESULTS: Postoperative air bone gap (ABG) increased as HRCT class increased from 0 to 3, meaning a more extensive otosclerotic focus (p=0.002). The comparison of the audiological outcomes, in accordance with the intraoperative findings, revealed that the postoperative air conduction pure-tone averages (AC PTA), ABG and ABG difference were higher in the white footplate group, with statistically significant differences compared to blue footplate group (p = 0.039, p = 0.001 and p=0.029, respectively). CONCLUSION: Postoperative audiological findings were found to be correlated with intraoperative and HRCT findings. A white footplate seen at surgery or a more extensive otosclerotic focus on temporal HRCT indicates a suboptimal audiological outcome. HRCT findings should be taken into account when planning the surgery. Key Words: Otosclerosis, Temporal bone HRCT, Footplate color, Stapedotomy, Audiometry.

Paratransgenic manipulation of a tsetse microRNA alters the physiological homeostasis of the fly's midgut environment.

Tsetse flies are vectors of parasitic African trypanosomes, the etiological agents of human and animal African trypanosomoses. Current disease control methods include fly-repelling pesticides, fly trapping, and chemotherapeutic treatment of infected people and animals. Inhibiting tsetse's ability to transmit trypanosomes by strengthening the fly's natural barriers can serve as an alternative approach to reduce disease. The peritrophic matrix (PM) is a chitinous and proteinaceous barrier that lines the insect midgut and serves as a protective barrier that inhibits infection with pathogens. African trypanosomes must cross tsetse's PM in order to establish an infection in the fly, and PM structural integrity negatively correlates with trypanosome infection outcomes. Bloodstream form trypanosomes shed variant surface glycoproteins (VSG) into tsetse's gut lumen early during the infection establishment, and free VSG molecules are internalized by the fly's PM-producing cardia. This process results in a reduction in the expression of a tsetse microRNA (miR275) and a sequential molecular cascade that compromises PM integrity. miRNAs are small non-coding RNAs that are critical in regulating many physiological processes. In the present study, we investigated the role(s) of tsetse miR275 by developing a paratransgenic expression system that employs tsetse's facultative bacterial endosymbiont, Sodalis glossinidius, to express tandem antagomir-275 repeats (or miR275 sponges). This system induces a constitutive, 40% reduction in miR275 transcript abundance in the fly's midgut and results in obstructed blood digestion (gut weights increased by 52%), a significant increase (p-value < 0.0001) in fly survival following infection with an entomopathogenic bacteria, and a 78% increase in trypanosome infection prevalence. RNA sequencing of cardia and midgut tissues from paratransgenic tsetse confirmed that miR275 regulates processes related to the expression of PM-associated proteins and digestive enzymes as well as genes that encode abundant secretory proteins. Our study demonstrates that paratransgenesis can be employed to study microRNA regulated pathways in arthropods that house symbiotic bacteria.

Evaluation of retinal vessel density and foveal avascular zone measurements in patients with obstructive sleep apnea syndrome.

PURPOSE: To compare retinal capillary plexus vessel densities, choroidal thickness, optic disc vessel densities and foveal avascular zone measurements between normal subjects and subjects with obstructive sleep apnea syndrome (OSAS) using spectral-domain OCT angiography (OCTA). METHODS: Forty eyes of patients with overall OSAS, 20 eyes of patients with mild-moderate OSAS, 20 eyes of patients with severe OSAS on polysomnography and 21 controls were evaluated with the RTVue-XR Avanti OCTA (Optovue, Inc., Fremont, CA). Superficial and deep retinal capillary plexus vessel densities, choroidal thickness and foveal avascular zone (FAZ) parameters (area, diameter, acircularity index of the FAZ, foveal density-300) were measured for all subjects. RESULTS: Superficial capillary plexus vessel densities of the groups were similar. Deep capillary plexus (DCP) vessel densities of all three OSAS groups decreased in the parafoveal region (< 0.001). In the perifoveal region, DCP vessel densities were decreased in the Overall OSAS group (p = 0.023) and in the Severe OSAS group (p = 0.021), whereas it was similar in the Mild-moderate OSAS group. Choroidal thickness decreased in all three OSAS groups (p < 0.001). All FAZ measurements and foveal density-300 measurements were similar compared to the control group. CONCLUSION: Our findings indicate that in severe OSAS patients, deep parafoveal, perifoveal vascular densities decrease and the choroid layer becomes thinner. When evaluating a patient with OSAS, it should be kept in mind that there may be eye involvement due to the disease.

Investigation of Phlebotominae (Diptera: Psychodidae) Fauna, Seasonal Dynamics, and Natural Leishmania spp. Infection in Mugla, Southwest of Turkey.

Due to its geographical location, Mugla province is one of the most frequently used places by refugees. Although leishmaniasis have been previously reported in this region, there is a lack of information on the etiological agent and possible vectors. The main objectives of this study were; i) to investigate the sand fly fauna, ii) to reveal the natural Leishmania spp. infection in wild caught sand flies using molecular tools, and iii) to determine the annual seasonal dynamics of the sand flies in Mugla region. Totally, 2093 specimens belonging to 15 species [12 Phlebotomus, three Sergentomyia; 51 unidentified] were collected during the one-year (June 2016- June 2017) period. Of the collected sand flies, 1928 (92.12%) were caught by the Centers for Disease Control (CDC) light traps, while 165 (7.88%) of them were caught by sticky traps. Phlebotomus major sensu lato (s.l.), the potential vector of visceral leishmaniasis (VL) and canine leishmaniasis (CanL) in the Mediterranean and Aegean region, was detected in all sampling locations and found as the dominant taxon (n=1035; 49.45%) of the study area and followed by Phlebotomus tobbi (n=371; 17.72%). During the sampling period, sand fly activity was started in March and peaked in August. Sand fly population size reduced dramatically between mid-September and early October. The number of collected specimens was peaked in August, while there is only one sample collected both in November and March. The majority of the sand flies (78.66%) were collected at an altitude range of 200-400 m. Seventy-two monospecific pools were screened for the presence of Leishmania DNA by real time ITS1 PCR and 24 (nine P. major s.l., eight P. tobbi, two P. papatasi, two S. minuta, one P. alexandri, one P. similis, and one Phlebotomus (Transphlebotomus spp.) of them (33.8%) were found positive (L. infantum, L. tropica, and L. major). To the best of our knowledge, the presence of fifteen sand fly species and their distribution, seasonal dynamics, molecular detection of Leishmania parasites in Mugla province was reported for the first time. The presence of vector species in the study area, appropriate temperature and humidity conditions, long sand fly activity season, and presence of Leishmania parasite suggests that there is a serious risk in the transmission of leishmaniasis in Mugla.

The effects of basketball and soccer training on arterial stiffness / Efeitos do treinamento de basquetebol e futebol sobre a rigidez arterial / Efectos del entrenamiento de básquetbol y fútbol sobre la rigidez arterial

ABSTRACT Objective The purpose of this study was to examine arterial stiffness in elite basketball and soccer athletes by pulse wave velocity. Methods The cohort comprised 35 healthy male volunteers aged 17 to 26 years. All the subjects were either basketball players (n=9), soccer players (n=12) or sedentary controls (n=14). Arterial stiffness was measured by the Pulse Trace System (Micro Medical Ltd., Rochester, UK) and echocardiographic images were taken using a commercially available machine (Vivid 7 GE-Vingmed, Horten, Norway) with a 2.5 MHz transducer. Results The basketball players had significantly higher heights and body weights as compared to both the soccer players and the controls. The aortic elastic properties derived from the echocardiographic measurements did not differ between the groups. The peripheral pulse wave velocity measurements showed significantly lower values both in the basketball and soccer players compared to the controls, whereas the central pulse wave velocity measurement was significantly lower only in the basketball players as compared to the controls. No significant difference was seen between the basketball and soccer players. Conclusions The results of this study show that football and basketball exercises comprised of aerobic, anaerobic, endurance balance-coordination and sport-specific training play a role in reducing arterial stiffness. Level of evidence I; type of study: prognostic study.

RESUMO Objetivo O propósito deste estudo foi examinar a rigidez arterial em atletas de basquetebol e futebol medindo a velocidade da onda do pulso. Métodos A coorte foi composta por 35 voluntários saudáveis do sexo masculino, com idade entre 17 a 26 anos. Os participantes eram jogadores de basquetebol (n = 9), jogadores de futebol (n = 12) e controles sedentários (n = 14). A rigidez arterial foi medida com o Pulse Trace System (Micro Medical Ltd., Rochester, Reino Unido) e as imagens ecocardiográficas foram obtidas com um aparelho disponível no mercado, com transdutor de 2,5 MHz (Vivid 7 GE-Vingmed, Horten, Noruega). Resultados Os jogadores de basquetebol tinham estatura e peso corporal consideravelmente superiores aos dos jogadores de futebol e aos controles. As propriedades elásticas aórticas derivadas das medicas ecocardiográficas não diferiram entre os grupos. A velocidade da onda de pulso periférico foi significativamente menor nos jogadores de basquetebol e futebol em comparação com os controles, enquanto os jogadores de basquetebol tiveram velocidade da onda do pulso central consideravelmente menor que os controles. Não se observou diferença significativa entre os jogadores de basquetebol e os de futebol. Conclusões Os resultados deste estudo mostram que os exercícios de treinamento de futebol e basquetebol: aeróbicos, anaeróbicos, de resistência, de coordenação e equilíbrio e os treinamentos específicos de cada esporte têm um papel importante na redução da rigidez arterial. Nível de Evidência I, Estudo prognóstico.

RESUMEN Objetivo El propósito de este estudio fue examinar la rigidez arterial en atletas de básquetbol y fútbol midiendo la velocidad de onda de pulso. Métodos La cohorte fue compuesta por 35 voluntarios saludables del sexo masculino, con edad entre 17 y 26 años. Los participantes eran jugadores de básquetbol (n=9), jugadores de fútbol (n=12) y controles sedentarios (n=14). La rigidez arterial fue medida con Pulse Trace System (Micro Medical Ltd., Rochester, Reino Unido) y las imágenes ecocardiográficas fueron obtenidas con un aparato disponible en el mercado, con transductor de 2,5 MHz (Vivid 7 GE-Vingmed, Horten, Noruega). Resultados Los jugadores de básquetbol tenían estatura y peso corporal considerablemente superiores a los de los jugadores de fútbol y a los de los controles. Las propiedades elásticas aórticas derivadas de las medidas ecocardiográficas no difirieron entre los grupos. La velocidad de onda de pulso periférico fue significativamente menor en los jugadores de básquetbol y fútbol en comparación con los controles, mientras que los jugadores de básquetbol tuvieron velocidad de onda de pulso central considerablemente menor que los controles. No se observó diferencia significativa entre los jugadores de básquetbol y los de fútbol. Conclusiones Los resultados de este estudio muestran que los ejercicios de entrenamiento de fútbol y básquetbol: aeróbicos, anaeróbicos, de resistencia, de coordinación y equilibrio y los entrenamientos específicos de cada deporte tienen un papel importante en la reducción de la rigidez arterial. Nivel de Evidencia I, Estudio pronóstico.

Evaluation of the Relationship Between the Required Pressure Level in Continuous Positive Airway Pressure Treatment and Voice in Patients With Obstructive Sleep Apnea Syndrome.

OBJECTIVE: The aim of this study was to investigate the effect of obstructive sleep apnea syndrome on voice, the relationship between the required pressure levels in continuous positive airway pressure (CPAP) and voice, and the effects of CPAP therapy on voice. MATERIAL AND METHODS: A total of 73 subjects consisting of 53 patients and 20 control subjects were included in the study. The patient group was further divided into low- (Group A) and high- (Group B) pressure groups according to the required pressure level. All subjects underwent acoustic sound analysis to evaluate fundamental frequency (F0), jitter, shimmer, and noise-to-harmonics ratio (NHR). Acoustic voice analysis was repeated after 3 months of regular CPAP treatment in the patient group. The mean F0, jitter, shimmer, and NHR values of the patient group and control group were compared. Intergroup comparisons were also performed between Group A and the control group, and between Group B and the control group. Finally, before and after CPAP treatment values of mean F0, jitter, shimmer, and NHR were compared in Group A and Group B. RESULTS: The mean shimmer and NHR values of the patient group were significantly higher than the control group (P = 0.01 and P = 0.023, respectively). The mean shimmer and NHR values of Group B were statistically higher than the control group (P = 0.002 and P < 0.001, respectively). The mean jitter, shimmer, and NHR values after CPAP treatment were significantly lower than those measured before CPAP treatment in Group B (P = 0.003, P = 0.001, and P = 0.001, respectively). CONCLUSION: Voice is negatively affected in obstructive sleep apnea syndrome patients who require high pressure in CPAP treatment. CPAP treatment leads to improved voice in these patients.

Investigation of pituitary dysfunction in retired professional soccer players / Investigação de disfunção hipofisária em jogadores de futebol profissionais aposentados / Investigación de disfunción hipofisaria en jugadores de fútbol profesionales retirados

ABSTRACT Introduction: It is well-known that pituitary dysfunction can develop as a result of traumatic brain injuries. One reason for such injuries is collision during contact sports. Objectives: The aim of this study was to investigate the effects of heading the ball and concussion on pituitary function in retired soccer players. Methods: Thirty-two retired soccer players, with an average age of 43.38 ± 5.49 (35-59) and 26 sedentary individuals with an average age of 43.31±6.38 (35-59) were included in this study. The subjects were questioned about their soccer-playing background, history of head trauma and concussion, and cardiometabolic diseases. One day one, blood samples were taken to investigate the baseline hematologic and biochemical parameters. On day two, the ACTH stimulation test was conducted, and on day three, glucagon stimulation tests were carried out. Resting EKG, transthoracic ECHO and exercise stress tests (for MET values) were also conducted. For the statistical analysis, The Student's t-test was used to compare the results of the two groups. The level of significance adopted was p<0.05. Results: It was identified that 5 out of 32 soccer players (16%) had experienced concussion during their soccer careers. The growth hormone (GH) levels of 3 retired soccer players (9.2%) and 3 sedentary individuals (10%) was below 1 ng/dl, which was accepted as the threshold value. There were no significant differences between hematological, biochemical and cardiometabolic parameters of the soccer players with low GH levels and those with normal GH levels. There was no significant relationship between the number of headers performed and GH deficiency. Conclusion: Although low GH levels were detected in almost 10% of the retired soccer players, the frequency of hypopituitarism was not higher than in the sedentary control group. Level of evidence I; Prognostic Studies.

RESUMO Introdução: É fato conhecido que a disfunção hipofisária sobrevém em decorrência de lesões cerebrais traumáticas. Uma das razões para essas lesões é a colisão durante esportes de contato. Objetivo: O objetivo deste estudo foi investigar os efeitos do cabeceamento de bola sobre a hipófise e suas funções em jogadores de futebol aposentados. Métodos: Participaram deste estudo 32 jogadores de futebol aposentados com média de idade de 43,38 ± 5,49 (35-59) e 26 indivíduos sedentários com média de idade de 43,31 ± 6,38 (35-59) que foram questionados quanto à experiência como jogador de futebol, história de traumatismo craniano, concussões e doenças cardiometabólicas. No primeiro dia, foram obtidas amostras de sangue para investigar os parâmetros hematológicos e bioquímicos basais. No segundo dia, foi realizado o teste de estimulação com ACTH; no terceiro dia, foram feitos os testes de estimulação com glucagon. Além disso, foram realizados ECG de repouso, ecocardiograma transtorácico e testes de esforço para obter o equivalente metabólico (MET). Na análise estatística, o teste t de Student foi usado na comparação dos resultados dos dois grupos. O nível de significância foi estabelecido em p < 0,05. Resultados: Identificou-se que cinco dos 32 jogadores de futebol (16%) sofreram uma concussão durante a carreira futebolística. Os níveis de hormônio de crescimento (GH) de três jogadores de futebol (9,2%) e de três indivíduos sedentários (10%) foram inferiores a 1 ng/dl, valor que foi aceito como limiar. Não houve diferença significativa entre os parâmetros hematológicos, bioquímicos e cardiometabólicos dos jogadores de futebol com deficiência de GH e os jogadores de futebol com nível normal de GH. Não houve relação significativa entre o número de cabeceamentos e a deficiência de GH. Conclusão: Embora a deficiência de GH tenha sido detectada em quase 10% dos jogadores aposentados, a frequência de hipopituarismo não foi maior do que a dos controles sedentários. Nível de evidência I; Estudos Prognósticos.

RESUMEN Introducción: Es un hecho conocido que la disfunción hipofisaria sobreviene a consecuencia de lesiones cerebrales traumáticas. Una de las razones para esas lesiones es la colisión durante deportes de contacto. Objetivo: El objetivo de este estudio fue investigar los efectos de la cabezada en la pelota sobre la hipófisis y sus funciones en jugadores de fútbol retirados. Métodos: Participaron en este estudio 32 jugadores de fútbol retirados con promedio de edad de 43,38 ± 5,49 (35-59) y 26 individuos sedentarios con promedio de edad de 43,31 ± 6,38 (35-59) que fueron cuestionados cuanto a la experiencia como jugador de fútbol, historia de traumatismo craneano, concusiones y enfermedades cardiometabólicas. En el primer día, fueron obtenidas muestras de sangre para investigar los parámetros hematológicos y bioquímicos basales. En el segundo día, fue realizado el test de estimulación con ACTH. En el tercer día, fueron hechos los tests de estimulación con glucagón. Además, fueron realizados ECG de reposo, ecocardiograma transtorácico y tests de esfuerzo para obtener el equivalente metabólico (MET). En el análisis estadístico se usó el test t de Student en la comparación de los resultados de los dos grupos. El nivel de significancia fue establecido en p<0,05. Resultados: Se identificó que cinco de los 32 jugadores (16%) sufrieron una concusión durante la carrera futbolística. Los niveles de hormona de crecimiento (HC) de tres jugadores de fútbol (9,2%) y de tres individuos sedentarios (10%) fueron inferiores a 1 ng/dl, valor que fue aceptado como umbral. No hubo diferencia significativa entre los parámetros hematológicos, bioquímicos y cardiometabólicos de los jugadores de fútbol con deficiencia de HC y los jugadores de fútbol con niveles normal de HC. No hubo relación significativa entre el número de cabezadas y la deficiencia de HC. Conclusión: Aunque la deficiencia de HC haya sido detectada en casi 10% de los jugadores retirados, la frecuencia de hipopituitarismo no fue superior a la de los controles sedentarios. Nivel de evidencia I; Estudios pronósticos.

Conventional and Diffusion-Weighted MR Imaging Findings of Parotid Gland Tumors.

OBJECTIVE: To investigate diffusion-weighted magnetic resonance imaging (MRI) findings of parotid gland lesions in addition to conventional MRI findings and demographic data. METHODS: A retrospective evaluation was made of the demographic data, histopathologic data, preoperative conventional and diffusion-weighted MRI of 74 patients who underwent parotidectomy. The patients were categorized according to the histopathology (pleomorphic adenoma [PA], Warthin's Tumor [WT] and malignant Tumor [MT]). RESULTS: Histologically, 30 patients had PA, 27 patients had WT, and the remaining 17 patients had MT. The mean age of the PA, WT and MT groups were 44±21 (20-72), 55±10 (41-71) and 62±20 (21-76) years, respectively. The WT (81%) and MT (70%) groups were male dominant, while the PA group showed female dominance (55%). The PA group showed statistically significant difference in terms of age (p<0.05) and gender (p=0.009) compared to the other two groups. The median apparent diffusion coefficient (ADC) values for the PA, WT and MT groups were 1.99±0.94 (1.10-2.41) × 10-3 mm2/s, 0.92±0.35 (0.21-1.79) × 10-3 mm2/s and 1.20±0.34 (0.78-1.47) × 10-3 mm2/s, respectively. PA was differentiated from the other two groups (p=0.001). The sensitivity and specificity for distinguishing PAs from WT was 97% and 85%, respectively, when the ADC cutoff value was 1.25; and for distinguishing PAs from MT was 77% and 83%, respectively, when the ADC cutoff value was 1.35. CONCLUSION: ADC measurements are useful for the differentiation of PA from both WT and MT; and can be used as a complementary tool to predict the histopathology in the preoperative planning of parotid tumors.

Impact of Nasal Trauma on Olfactory Function.

OBJECTIVE: To determine the impact of nasal trauma with and without the potential to produce nasal fracture on the olfactory function. STUDY DESIGN: A descriptive analytical study. PLACE AND DURATION OF STUDY: Ear, Nose, Throat Clinic, Ankara Numune Training and Research Hospital, Ankara from October 2018 to June 2019. METHODOLOGY: The study included patients with nasal trauma and control subjects. The patients with nasal trauma were divided into two groups as fracture group (Group F, n=83) and non-fracture group (Group Non-F, n=30). The Group F was further divided into two subgroups according the presence as septal fracture as Group SF (patients with septal fracture) and Group Non-SF (patients with non-septal fracture). The smell functions of all participants were evaluated using the Sniffin' Sticks test. The odour scores of Group F and Group Non-F were compared versus control group, using the independent sample t-test or Mann-Whitney U-test. Percentage of patients with olfactory dysfunction was compared between Group F and Group Non-F and between Group SF and Group Non-SF using the Chi-square test. RESULTS: There were a total of 113 participants with mean age of 35.64±10.44 years. The median TDI score of Group F was significantly lower in comparison to control group, no significant difference was found between Group Non-F and control group in terms of median TDI score. There was a significant difference between Group F and Group Non-F in terms of the percentage of patients with olfactory dysfunction. No significant difference was found between Group F and Group Non-F with respect to the percentage of patients with olfactory dysfunction. CONCLUSION: Nasal trauma can lead to olfactory dysfunction only if it has the potential to produce a nasal fracture. Key Words: Smell disorders, Nasal bone, Bone fractures, Trauma.

First molecular detection and identification of Leishmania species in small wild rodents from Turkey.

Leishmaniasis is a parasitic disease infecting animals and humans. Two clinical forms (Visceral and cutaneous leishmaniasis) and four species are reported to be present in Turkey. Several studies have investigated canine and human leishmaniasis in Turkey but no study was performed to screen the infection among wild rodents, so far. The present study aims to investigate the role of small wild rodents as reservoir animals for Leishmania spp. in different regions of Turkey. Formalin-preserved tissue samples (spleen, liver, lung) of 712 rodents from 30 provinces were screened for the presence of Leishmania spp. DNA. Before DNA extraction, tissues were dried, rehydrated, and homogenated. Leishmania screening in rodent tissues and species determination was performed with a combination of real-time kDNA and ITS1 polymerase chain reaction protocols. Eight (1.12%) out of 712 animals were found to be positive for Leishmania spp. DNA and species typing revealed five L. infantum, two L. tropica and one L. major among positives. Leishmania major and L. infantum DNA were detected in Apodemus spp. from Zonguldak province located in the Western Black Sea Region, while L. tropica DNA was found in Meriones sp. and Gerbillus dasyurus from Adana and Hatay provinces located in Eastern Mediterranean Region of Turkey. The present study is first to report natural infection of L. infantum, L. major and L. tropica in small wild rodents in Turkey, suggesting their possible roles as reservoirs. Further studies are needed for planning epidemiological studies and also for developing rodent control measures in risky endemic areas to break the transmission cycle.