Galectin-3 levels in children with cystic fibrosis.

Cystic fibrosis (CF) is a multisystemic disease in which airway obstruction, infection, and inflammation play a critical role in the pathogenesis and progression of CF lung disease. The carbohydrate-binding protein Galectin-3 is increased in several inflammatory and fibrotic diseases and has recently been forwarded as a biomarker in these diseases. We aimed to define the role of serum Galectin-3 in children with CF by comparison with healthy subjects. This is a cross-sectional, case-control study. 143 CF and 30 healthy subjects were enrolled in the study. Peripheral blood and sputum concentrations of Galectins-3, interleukin (IL)-17A, IL-8, and neutrophil elastase (NE) were determined with commercial ELISA kits. There was no significant difference between the groups in age and gender (p = 0.592, p = 0.613, respectively). Serum Galectin-3 and NE concentrations were higher in the patient group than in healthy controls (p = 0.002, p < 0.001, respectively). There were no significant differences between groups according to IL-17A and IL-8 concentrations. Serum Galectin-3 was correlated with age (r = 0.289, p < 0.001) and body mass index (BMI) (r = 0.493, p < 0.001) in children with CF. Sputum Galectin-3 levels are negatively correlated with percent predictive forced expiratory volume in 1 s (FEV1) (r = - 0.297, p = 0.029), FEV1 z-score, (r = - 0.316, p = 0.020), percent predictive forced vital capacity (FVC) (r = - 0.347, p = 0.010), and FVC z-score (r = - 0.373, p = 0.006).   Conclusion: The study shows that serum Galectin-3 levels increased in clinically stable CF patients, and serum Galectin-3 response may depend on age, gender, and BMI. The sputum Galectin-3 was found to be negatively correlated with patients' lung functions. What is known: • Galectin-3 is a key regulator of chronic inflammation in the lung, liver, kidney, and tumor microenvironment. What is new: • Children with cystic fibrosis (CF) have higher serum Galectin-3 concentrations than healthy children. • Serum Galectin-3 expression influenced by age, BMI, and gender in children with CF.

Intraventricular Hemorrhage and Related Hydrocephalus Patients Demographics in a University Hospital NICU: Single-Center Data.

AIM: To analyze the demographic and clinical data of preterm or low birth weight newborns with periventricular hemorrhage. MATERIAL AND METHODS: This retrospective study analyzed patients admitted to the neonatal intensive care unit of a Bahcesehir University School of Medicine-Affiliated Hospital due to preterm birth or low birth weight between June 1, 2012, and April 30, 2021. Categorical values were evaluated by Pearson chi-square or Fisher's exact test. The Mann-Whitney U test compared continuous values between the groups. Logistic regression was used to evaluate the factors that affected permanent cerebrospinal fluid (CSF) diversion. RESULTS: The study finally evaluated 180 newborns. Ninety-one newborns (50.5%) had grade I, 18 (10%) had grade II, 22 (12.2%) had grade III, and 49 (27.2%) had grade IV hemorrhage. One hundred and forty-nine patients (82.8%) were delivered by cesarean section, and 31 (17.2%) were delivered vaginally. All patients with low-grade hemorrhage who needed temporary CSF diversion eventually required permanent CSF diversion. For high-grade hemorrhage, 15 (grade III, 1; grade IV, 14) of 51 (29.4%) patients with ventricular access device (VAD) insertion required permanent CSF diversion. Fifteen (grade III, 6; grade IV, 9) of these 51 (29.4%) patients did not need permanent CSF diversion; thus, their VADs were removed. CONCLUSION: The permanent CSF diversion rate was significantly higher in the high-grade hemorrhage group, which had significantly lower weight and gestational age at birth. Moreover, only weight at VAD insertion had minimal effect on the need for permanent CSF diversion.

Ultrasound-Responsive Nanodroplet-Based Targeted Therapy via Conversion to Microbubbles.

Ultrasound-based therapy is appealing as it can be used via a wireless approach at remote parts of the body including the brain. Microbubbles are commonly used in such therapy due to their highly sound-responsive property. However, the larger size of microbubbles limits selective targeting in vitro/in vivo. Here, we report the design of nanodroplets of 70-130 nm in size that can be easily converted to microbubbles via ultrasound exposure. The advantage of this approach is that smaller nanodroplets can be used for cell/subcellular targeting, and next, they can be used for therapy by converting to microbubbles. More specifically, folate/dopamine-terminated perfluorohexane nanodroplets are designed that are loaded with a molecular drug. These nanodroplets are used for selective cell targeting, followed by ultrasound-induced microbubble conversion that is associated with drug release and intracellular reactive oxygen species generation. This approach has been used for selective cell therapy applications. The designed nanodroplet and approach can be used for the enhanced therapeutic performance of existing drugs.

Time-varying disaggregation of the income-emissions nexus: New evidence from the United Kingdom.

This paper's objective is to investigate the validity of the Environmental Kuznets Curve (EKC) hypothesis utilizing three unique approaches in this era of accelerating climate change and economic volatility. The first step is to introduce and employ a new cointegration test which allows smooth and sharp structural changes through a dummy variable and a Fourier function. Using a time-varying causality approach, the second stage is to assess the EKC hypothesis's validity for each year of a given period, as opposed to the entire period. The third stage is to conduct time-varying analyses not only of the effect of Gross Domestic Product or aggregate income on environmental degradation but also of the effects of the four major economic units' incomes, namely those of the government, non-financial corporations, households, and the rest of the world. This research derives three conclusions using the United Kingdom as a case study from 1830 to 2016. The impacts of aggregate income and the incomes of the three economic units on carbon emissions are consistent with the EKC hypothesis. Second, each of these effects occurs at different times. Thirdly, the EKC hypothesis regarding the association between the nation's trade income and carbon emissions cannot be validated. To provide policymakers with a dynamic, unit-specific, and effective strategy for mitigating environmental degradation, the paper proposes testing the EKC hypothesis for each year over a specific time period, as well as for the effects of both aggregate income and the disaggregate income of four major economic units.

Oxidative response of sheep to transcervical applications.

This study aimed to investigate the stress-related changes that may occur in sheep following non-surgical cervical line passage. A total of 20 sheep underwent transcervical transition, and their heart rate, respiratory rate, body temperature, and blood samples were collected at specific time points: 1 h prior to the procedure, immediately after the procedure, and at 1, 2, 3, 4 and 5 h post-procedure. The study found that there was a statistically significant decrease in body temperature immediately after the procedure (p < .05); however, there were no significant differences in body temperature at other time points (p > .05). Respiratory rate remained similar throughout the study, and no significant differences were observed (p > .05). On the other hand, there was a significant increase in heart rate at the 1-h mark after the procedure (p < .05), which subsequently decreased to a similar level as the control group at the 4-h mark after the procedure (p > .05). The cortisol levels increased significantly after the application (p < .05) but decreased to a level similar to the control after 1 h (p > .05). The level of nitric oxide increased significantly in the first hour (p < .05) and decreased by the 5th hour (p < .05). There was a significant increase in malondialdehyde (MDA) and total oxidant capacity (TOC) levels 2 h after the application (p < .05), but this increase ceased at the 4th and 5th hours for MDA (p > .05) and at the 3rd, 4th and 5th hours for TOC (p > .05). The total antioxidant capacity decreased after the 2nd hour of application (p < .05) but remained similar at the fourth and 5th hours (p > .05). In conclusion, based on the cortisol data, transcervical manipulations create short-term stress. Therefore, it may be necessary to use various antioxidants before such procedures to reduce the effects of oxidative stress.

Quantitative analysis of the olfactory system in pediatric epilepsy: a magnetic resonance imaging study

PURPOSE: Olfactory dysfunction is a well-known complication in epilepsy. Studies have demonstrated that olfactory bulb volume (OBV), olfactory tract length (OTL), and olfactory sulcus depth (OSD) can be reliably evaluated using magnetic resonance imaging (MRI). In this study, we compared the OBV, OTL, and OSD values of children with epilepsy and those of healthy children (controls) of similar age. Our aim was to determine the presence of olfactory dysfunction in children with epilepsy and demonstrate the effects of the epilepsy type and treatment on olfactory function in these patients. METHODS: Cranial MRI images of 36 patients with epilepsy and 108 controls (3-17 years) were evaluated. The patients with epilepsy were divided into groups according to the type of disease and treatment method. Subsequently, OBV and OSD were measured from the coronal section and OTL from the sagittal section. The OBV, OTL, and OSD values were compared between the epilepsy group, subgroups, and controls. RESULTS: OBV was significantly reduced in the children with epilepsy compared with the control group (P < 0.001). No significant difference between the healthy children and those with epilepsy was determined in terms of OTL and OSD. Although OBV was moderately positively correlated with age in the control group (r = 0.561, P < 0.001), it was poorly correlated with age in children with epilepsy (r = 0.393, P = 0.018). CONCLUSION: The results of our study indicate that OBV decreases in children with epilepsy, but epilepsy type and treatment method do not affect OBV, OTL, or OSD (P > 0.05).

Why are some countries cleaner than others? New evidence from macroeconomic governance.

This study aims to investigate why some countries are cleaner than the others with reference to macroeconomic governance (MEG) in order to explain how major macroeconomic aggregates should be governed to mitigate environmental pollution at the level of economic systems. Using per capita carbon dioxide emissions (CPC) as the proxy for air pollution, and macro-non-financial governance (MNFG) and macro-financial governance (MFG) as the proxies for MEG, the study introduces the systemic and fragmented governance of green complementarities (GCMs) and dirty complementarities (DCMs) as analytic concepts to compare the MEG models for managing pollution in 13 high-income countries (HICs), 10 upper-middle-income countries (UMICs), and nine lower-middle-income countries (LMICs) for the period 1994-2014. The paper concludes that (i) HICs reduced their CPC levels thanks to adopting green systemic governance by creating GCMs between both MNFG and MFG variables in the long run; (ii) UMICs experienced a remarkable increase in their CPC levels due to adopting dirty systemic governance by creating DCMs between the MNFG variables, but prevented pollution from being higher through creating GCMs between the MFG variables; and (iii) LMICs experienced the highest comparative increase in CPC due to adopting a fragmented governance in managing both MNFG-pollution and MFG-pollution nexus.

Efficacy of combination therapy with biofeedback and dapoxetine in lifelong premature ejaculation treatment: a prospective randomized study.

PURPOSE: Premature ejaculation (PE) is a common sexual dysfunction that significantly affects the quality of life of the patient and their partner. We aimed to compare the efficacy and safety of the combination therapy with biofeedback-guided pelvic floor exercise therapy (BFT) and dapoxetine 30 mg. METHODS: Sixty-five patients diagnosed with lifelong PE were included in the study. Patients were divided into three groups as BFT, dapoxetine 30 mg and a combination of BFT and dapoxetine 30 mg. The patients were compared with the intravaginal ejaculatory latency time (IELT) pre-treatment and post-treatment 1st and 3rd months. RESULTS: The mean IELTs of the patients in Group 1 were 40 s in pre-treatment, 115 s at the end of the 4th week and 140 s at the end of the 12th week. The IELT values of the patients in Group 2 were 40 s in pre-treatment, 145 s in the 4th week and 170 s in the 12th week. The IELT values were calculated in Group 3 as 42.5 s in pre-treatment, 185 s in the 4th week and 205 s in the 12th week When the IELT was statistically compared between the groups at 1st and 3rd months, the duration in the combination group was found to increase significantly (p < 0.001). CONCLUSION: Combination therapy with BFT and dapoxetine 30 mg in lifelong PE treatment is a good alternative with a low side effect profile and acceptable continuous efficiency.

Oxidative stress in neonatal lambs and its relation to health status and passive colostral immunity.

Oxidative stress (OS) related to birth in ruminants may increase susceptibility to diseases. However, information about the physiological changes related to OS in lambs is limited. This study was designed to evaluate changes in OS parameters [total antioxidant status (TAS, mmol Trolox Equiv./L), total oxidant status (TOS, µmol H2O2 Equiv./L)] and calculated oxidative stress index (OSi = TOS/TAS * 100, Arbitrary Unit) and its association with passive colostral transfer immunity and health status in neonatal Akkaraman crossbreed lambs. Control group of healthy lambs (n = 15) were blood sampled before (day 0) and after colostrum intake (on day 1, 2, 4, 7, 14 and 28) in order to evaluate the effect of colostrum intake on TAS, TOS and OSi over time. In addition, a group of lambs (experimental group, n = 60), based on their health status and different cut off value of IgG (mg/dL), was also blood sampled at 24 ± 1 h of colostrum ingestion to determine the relationship between OS parameters, IgG and health status. OS was evident at birth and gradually decreased in control group as TOS (days 0:8.06 ± 0.64, 1:7.05 ± 0.51, 2:5.23 ± 0.35, 4:5.05 ± 0.2, 7:5.13 ± 0.34, 14:3.75 ± 0.12 and 28:3.73 ± 0.15 µmol H2O2 Equiv./L), OSi (days 0: 8.35 ± 0.64, 1: 9.17 ± 1.05, 2:6.83 ± 0.6, 4:6.30 ± 0.20, 7:6.67 ± 0.59, 14:4.46 ± 0.19 and 28:4.87 ± 0.29 au) and TAS (days 0: 0.97 ± 0.02, 1:0.82 ± 0.04, 2:0.81 ± 0.05, 4:0.81 ± 0.02, 7:0.80 ± 0.03, 14:0.85 ± 0.02 and 28:0.79 ± 0.03 mmol Trolox Equiv./L) values changed over time. In the experimental group, the lambs died in the first week of the neonatal period had higher levels of TOS (10.3 ± 0.90 µmol H2O2 Equiv./L) and OSi (1.61 ± 0.22 au) than healthy ones (TOS:6.90 ± 0.36 µmol H2O2 Equiv./L, OSi:1.12 ± 0.11 au) (P < 0.001). The gradual decrease in OS in the neonatal period was accepted as a sign of improved antioxidant response. The study disclosed that deaths may develop when OS at birth is not balanced by sufficient amount and quality of colostrum an important source of antioxidants such as enzymes and vitamins. The study presented may provide new information in the field of study on oxidative stress in neonatal lambs and help to prevent deaths in the first week of life. It can also be useful in developing preventive measures such as supplements of antioxidants to colostrum.

Is biofeedback-assisted pelvic floor muscle training superior to pelvic floor muscle training alone in the treatment of dysfunctional voiding in women? A prospective randomized study

ABSTRACT Purpose: To compare the effectiveness of biofeedback-assisted pelvic floor muscle training (PFMT) and PFMT alone on voiding parameters in women with dysfunctional voiding (DV). Materials and Methods: The patients in group 1 (34 patients) were treated with biofeedback-assisted PFMT, and the patients in group 2 (34 patients) were treated with PFMT alone for 12 weeks. The 24-hour frequency, average voided volume, maximum urine flow rate (Qmax), average urine flow rate (Qave), post-void residual urine volume (PVR), and the validated Turkish Urogenital Distress Inventory (UDI-6) symptom scores were recorded before and after 12 weeks of treatment. Results: At the end of treatment sessions, the Qmax and Qave values of the patients in group 1 were significantly higher than those in group 2, and the PVR in the patients in group 1 was significantly lower than those in group 2 (p=.026, .043, and .023, respectively). The average UDI-6 symptom scores of the patients in group 1 were significantly lower than those in group 2 (p=.034). Electromyography activity during voiding, in group 1 was significantly lower than in group 2 (41.2 vs. 64.7, respectively, p=.009). Conclusion: Biofeedback-assisted PFMT is more effective than PFMT alone in improving clinical symptoms, uroflowmetry parameters, and EMG activity during voiding.

A rationally designed synthetic antimicrobial peptide against Pseudomonas-associated corneal keratitis: Structure-function correlation.

Contact lens wearers are at an increased risk of developing Pseudomonas-associated corneal keratitis, which can lead to a host of serious ocular complications. Despite the use of topical antibiotics, ocular infections remain a major clinical problem, and a strategy to avoid Pseudomonas-associated microbial keratitis is urgently required. The hybrid peptide VR18 (VARGWGRKCPLFGKNKSR) was designed to have enhanced antimicrobial properties in the fight against Pseudomonas-induced microbial keratitis, including contact lens-related keratitis. In this paper, VR18's modes of action against Pseudomonas membranes were shown by live cell Raman spectroscopy, live cell NMR, live-cell fluorescence microscopy and measures taken using sparsely tethered bilayer lipid membrane bacterial models to be via a bacterial-specific membrane disruption mechanism. The high affinity and selectivity of the peptide were then demonstrated using in vivo, in vitro and ex vivo models of Pseudomonas infection. The extensive data presented in this work suggests that topical employment of the VR18 peptide would be a potent therapeutic agent for the prevention or remedy of Pseudomonas-associated microbial keratitis.

Is biofeedback-assisted pelvic floor muscle training superior to pelvic floor muscle training alone in the treatment of dysfunctional voiding in women? A prospective randomized study.

PURPOSE: To compare the effectiveness of biofeedback-assisted pelvic floor muscle training (PFMT) and PFMT alone on voiding parameters in women with dysfunctional voiding (DV). MATERIALS AND METHODS: The patients in group 1 (34 patients) were treated with biofeedback-assisted PFMT, and the patients in group 2 (34 patients) were treated with PFMT alone for 12 weeks. The 24-hour frequency, average voided volume, maximum urine flow rate (Qmax), average urine flow rate (Qave), post-void residual urine volume (PVR), and the validated Turkish Urogenital Distress Inventory (UDI-6) symptom scores were recorded before and after 12 weeks of treatment. RESULTS: At the end of treatment sessions, the Qmax and Qave values of the patients in group 1 were significantly higher than those in group 2, and the PVR in the patients in group 1 was significantly lower than those in group 2 (p=.026, .043, and .023, respectively). The average UDI-6 symptom scores of the patients in group 1 were significantly lower than those in group 2 (p=.034). Electromyography activity during voiding, in group 1 was significantly lower than in group 2 (41.2 vs. 64.7, respectively, p=.009). CONCLUSION: Biofeedback-assisted PFMT is more effective than PFMT alone in improving clinical symptoms, uroflowmetry parameters, and EMG activity during voiding.

A multicentre prospective analysis of the incidence of pemphigoid diseases in Turkey.

BACKGROUND: The differentiation between the pemphigoid diseases is essential for treatment and prognosis. In Turkey, data on the incidence of these diseases are insufficient. Our aim in this study is to determine the incidence, demographics and clinical characteristics associated with diseases of the pemphigoid group. METHODS: We prospectively analysed 295 patients with pemphigoid who visited dermatology clinics of tertiary referral hospitals in 12 different regions of Turkey within a year. The diagnosis was based on clinical, histopathological, direct immunofluorescence (DIF) and serological (multivariant enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence and mosaic-based BIOCHIP) examinations. Clinical and demographic findings, aetiological factors and concomitant diseases observed in the patients were recorded. RESULTS: A total of 295 (female/male ratio: 1.7/1) patients with pemphigoid were diagnosed in 1-year period. The overall incidence rate of pemphigoid diseases was found to be 3.55 cases per million-years. The ratio of pemphigoid group diseases to pemphigus group diseases was 1.6. The most common pemphigoid type was bullous pemphigoid (BP, 93.2%). The others were epidermolysis bullosa acquisita (3.1%), pemphigoid gestationis (2.4%), linear IgA disease (1%) and mucous membrane pemphigoid (0.3%). The most common (26.8%) possible trigger of the bullous pemphigoid was gliptin derivative drugs. The most common concomitant diseases with pemphigoid were cardiovascular (27.8%) and neurological diseases (23.7%). CONCLUSIONS: This study showed that the increased frequency of bullous pemphigoid reversed the pemphigoid/pemphigus ratio in Turkey. Further studies are warranted regarding the reasons for this increase.

Is Increased Intracranial Pressure a Factor in Persistent Headache After Coronavirus Disease 2019?

ABSTRACT: This study aimed to determine pain characteristics in patients with persistent headache after COVID-19 and to investigate the role of increased intracranial pressure (ICP) in the pathogenesis of this headache. This is a case-control study comparing the parameters and measurements indicating increased ICP based on magnetic resonance imaging between COVID-19-diagnosed patients with persistent headache and a control group. Optic nerve sheath diameter (ONSD) and eyeball transverse diameter (ETD) were performed on the left eye of each participant. Seventeen of the patients (53.12%) met the diagnostic criteria for new daily persistent headache. Seven patients (21.87%) had migraine, and eight (25%) had tension headache characteristics. No significant difference was observed between the patient and control groups in terms of the ONSD and ETD values. It is possible that the etiopathogenesis is multifactorial. We consider that future studies that will evaluate ICP measurements in large patient groups can present a different perspective for this subject.

A review of hypogonadotropic hypogonadism cases followed up in our clinic in the last decade.

INTRODUCTION: The aim of the present study was to evaluate, with this retrospective study, the patients with hypogonadotropic hypogonadism, who were followed up in our clinic in the last decade and were reviewed in terms of the incidence of the disease, diagnostic methods and differential diagnoses, treatment modalities, fertility rates, and treatment success. METHODS: After a very careful differential diagnosis, 81 patients (1.5% of infertile men presenting to the outpatient clinic) were diagnosed with hypogonadotropic hypogonadism. This study only included patients diagnosed with idiopathic hypogonadotropic hypogonadism. The treatment was undertaken in two periods depending on whether or not the patients wanted to have children at that time: testosterone replacement therapy and gonadotropin therapy. To induce spermatogenesis, the patients were treated using human chorionic gonadotropin and urinary or recombinant follicle-stimulating hormone. RESULTS: The pregnancy rates of the spouses of the patients were as follows: spontaneous 64.6% (n = 42), intrauterine insemination 12.3% (n = 8), in vitro fertilization 15.3% (n = 10), and microscopic testicular sperm extraction + intracytoplasmic sperm injection 4.6% (n = 3). CONCLUSION: Idiopathic hypogonadotropic hypogonadism is a rare but easily diagnosable and treatable cause of male infertility. After a long period of the treatment, almost all idiopathic hypogonadotropic hypogonadism patients can be treated with gonadotropins (human chorionic gonadotropin + follicle-stimulating hormone) in order to have children. The most important issue in the treatment is the dose of the drugs used in the treatment and the duration of the treatment. The most important result is that the required gonadotropin dose varies according to each patient. Therefore, the treatment dose and duration should be increased until patients have children.

Ultra-mini flexible percutaneous nephrolithotomy in the treatment of moderate-size kidney stones: a new instrument, a preliminary prospective study.

Ultra-mini PNL is increasingly preferred in the treatment of kidney stones. Unlike routine applications of the ultra-mini PNL technique, we aimed to perform kidney stones treatment with an epiduroscopic device that can pass through 11-13-Fr ureteral access sheaths with a flexible structure and which is routine in neurosurgical practice. The study was planned prospectively. The study included 52 patients with mid-sized kidney stones who had presented to our clinic between July 2017 and January 2019. The ultra-mini percutaneous nephrolithotomy was carried out with epiduroscopy routinely used in neurosurgery practice, which can pass through 11-13-Fr ureteral access and has a flexible structure. The perioperative and postoperative parameters were analyzed. The mean operation time was 45.6 ± 4.8 min and entry was provided through a single entry (from the calyx appropriate to the lower pole) in all patients; a second entry tract was not required. No DJ catheter or nephrostomy tube was installed in any patient and the procedures were completed totally without a tube. The mean reduction in hemoglobin values was determined as 0.33 (0.1-1.1) g/dL. None of the patients needed transfusion and no patient developed acute kidney injury. Clinically significant (≥ 3 mm) residual stone was observed in 2 (4%) of the 52 patients, while clinically insignificant (≤ 3 mm) stones were observed in 50 patients (96%). The mean length of hospital stay was 2.5 ± 0.9 days. Ultra-mini flexible percutaneous nephrolithotomy is an effective and safe method in the treatment of medium-sized kidney stones.

TzanckNet: a convolutional neural network to identify cells in the cytology of erosive-vesiculobullous diseases.

Tzanck smear test is a low-cost, rapid and reliable tool which can be used for the diagnosis of many erosive-vesiculobullous, tumoral and granulomatous diseases. Currently its use is limited mainly due to lack of experience in interpretation of the smears. We developed a deep learning model, TzanckNet, that can identify cells in Tzanck smear test findings. TzanckNet was trained on a retrospective development dataset of 2260 Tzanck smear images collected between December 2006 and December 2019. The finalized model was evaluated using a prospective validation dataset of 359 Tzanck smear images collected from 15 patients during January 2020. It is designed to recognize six cell types (acantholytic cells, eosinophils, hypha, multinucleated giant cells, normal keratinocytes and tadpole cells). For 359 images and 6 cell types, TzanckNet made 2154 predictions. The accuracy was 94.3% (95% CI 93.4-95.3), the sensitivity was 83.7% (95% CI 80.3-87.0) and the specificity was 97.3% (95% CI 96.5-98.1). The area under the receiver operating characteristic curve was 0.974. Our results show that TzanckNet has the potential to lower the experience barrier needed to use this test, broadening its user base, and hence improving patient well-being.

Predictive value of perfusion index for mortality in mechanically ventilated patients.

AIM: This study aimed to examine the prognostic significance of the perfusion index (PI) in mechanically ventilated patients. METHODS: Study included sixty patients who had the risk factors for the development of acute respiratory distress syndrome and received mechanical ventilator (MV) support in intensive care unit (ICU) unit between January 2017/January 2018. The demographic characteristics, vital signs, blood gas parameters, lactate levels, prognostic scores, and use of inotropic drugs were recorded. Arterial blood gas and PI measurements at the frontal region were performed at the time of and 12th and 24th hours of admission to the ICU. The patients were followed up for 60 days, and the outcome was recorded. RESULTS: Twelve patients (20%) died during the first 7 days, and 27 patients (45%) died within 60 days of the admission. Multivariate analyses to determine potential predictors of 7 and 30-day mortality showed that only 24th-hour lactate level was independent predictor of 60-day mortality, and the PI at 24th was the sole independent predictor of 7-day mortality. CONCLUSION: The PI did not predict 60-day mortality in MV patients who had risk factors for the development of Acute Respiratory Distress Syndrome (ARDS). However, the PI at 24th may be a significant predictor of 7-day mortality.

ABO and Rh Blood Groups and Risk of Myelomeningocele.

AIM: To investigate the relationship between the distribution of ABO or Rhesus (Rh) blood group antigens and the incidence of myelomeningocele. MATERIAL AND METHODS: A retrospective data was reviewed for all myelomeningocele patients operated at a tertiary academic hospital between years 2014 and 2019. Age, sex, delivery method, physical and neurological examination findings, and radiological findings alongside with blood type of each patient were recorded. The data of blood group distribution among the study patients was compared to the data of healthy individuals in the same region. RESULTS: Patients with group B and AB showed a higher chance of developing myelomeningocele. Rh-positive blood group was associated with high incidence of myelomeningocele (93.5%), whereas Rh-negative blood group showed least association (6.5%). Rh-positive blood group was also found to be more frequent in patients with myelomeningocele with hydrocephalus and Chiari malformation. CONCLUSION: The findings of this study show that ABO and Rh blood groups have an effect on the development of myelomeningocele under the influence of environmental or genetic factors.