Pulmonary Physician Consultancy in Emergency Services in Turkiye (PuPCEST) - a cross-sectional multicenter study.

Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates.

The Determination Of The Relationship Between Vo2max And The Angiotensin-Converting Enzyme Gene (ACE) rs1799752 Polymorphisms In The Turkish National Ice Hockey Sports Team.

In the present study, the effect of ACE rs1799752 polymorphism on maximal oxygen consumption (VO2max) in ice hockey players was analyzed. For this reason, 21 male National Ice Hockey players, aged between 18-25, were recruited for the study. The conventional polymerase chain reaction (PCR) was used on the genotype rs1799752 polymorphism. The VO2max values were calculated by using the 20m Shuttle Run tests. The numbers and percentages of the II, ID and DD genotypes were 9 (%43), 7 (%33), and 5 (%24), respectively. The allelic distribution for I and D alleles was found to be 25 (60%) and 17 (40%), respectively. The mean VO2max of all the athletes was calculated as 47.52 ml. The mean VO2max of the II, ID, and DD genotypes were 49.74ml, 47.34 ml, and 46.43 ml, respectively. We found that the oxygen utilization capacity increased from the DD genotype to the II genotype. However, this increase was not statistically significant (p> 0.05). In order to confirm our findings, it is recommended that larger prospective studies depending on the effect of the relevant polymorphisms needed to be carried out.

Development of a new and sensitive method for the detection of pork adulteration in gelatin and other highly processed food products.

Porcine adulteration has become a major concern amongst communities including Muslims and Jews. Reliable detection of the presence of porcine DNA in gelatin and highly processed food samples is essential for Halal and kosher food control. In this study, a forensic approach involving DNA isolation and real-time polymerase chain reaction (PCR) was performed to detect the presence of porcine DNA in commercial gelatin and processed foods containing porcine by-products. The method was compared with commercially sensitive porcine DNA detection kits (Biotecon and R-Biopharm) which are commonly used in food control laboratories for Halal and kosher authentication. The results indicated that a newly developed method called TübiGel was at least 10 times more sensitive for porcine DNA detection. The TübiGel method was found to have a detection limit of 0.01% porcine gelatin, whilst the Biotecon method had 0.1% and R-Biopharm method detected >5% porcine gelatin. The forensic DNA isolation approach of the TübiGel method was found to be a critical step. In addition, real-time PCR of TübiGel method was also found to detect porcine DNA better than real-time PCR of commercial kits.

Distribution of α-actinin-3 rs1815739 and angiotensin-1 converting enzyme InDel polymorphisms in Turkish bodybuilders.

The determination of the genetic profiles of successful athletes and the effects of these genetic parameters on athletic performance is gaining increasing interest. The majority of studies assessing the genetics of athletes usually analyse the most well-known genetic variations in athletes associated with the different specialties. The aim of the present study was to analyse the ACE InDel and ACTN3 rs1815739 polymorphisms in Turkish bodybuilders. A total of 11 male bodybuilders were recruited and genotyped for these polymorphisms. The respective percentage of the ACE II, ID and DD genotypes were 18, 73 and 9. For the ACTN3 genotype, the respective frequencies were 55 and 45 for the RX and RR genotypes. No XX genotype was detected. The allelic counts were 12 (55%) for I and 10 (45%) for the D alleles of ACE; and 12 (55%) and 10 (45%) for R and X alleles, respectively, for the ACTN3 genotype. Additionally, 5 athletes had ID + RX genotypes in terms of ACE InDel and ACTN3 rs1815739 polymorphisms, respectively. These results indicate the importance of endurance related alleles of ACE and ACTN3 in bodybuilders. The results of the present are in agreement with previous studies, highlighting a potential association between specific polymorphisms and the endurance-related nature of bodybuilders. Further studies with larger cohorts are required to understand the association between these polymorphisms and specific parameters performance in bodybuilders.

Effect of Different Surface Treatments and Roughness on the Repair Bond Strength of Aged Nanohybrid Composite.

Objective and background: Different surface treatments have been tested in composite repair studies. However, there is still no consensus on the most effective repair protocol. The aim of this study is to measure the roughness values of eight different surface treatments for the repair procedure, to examine the effect of each surface treatment and three different composites on the repair bond strength with and without silane, and to evaluate whether there is a correlation between bond strength and roughness. Methods: The blocks were prepared with Filtek Z550 (3M ESPE) for the roughness measurements and divided into eight groups according to surface treatments. The roughness values of the surface treatments were measured by a 3D scanning contact profilometer (Nanomap LS). For the shear test, further samples were prepared, aged, and divided into three subgroups for the repair procedure with Filtek Z550 (3M ESPE), Vertise Flow (Kerr, USA), and G-aenial Flo (GC, Japan) after the surface treatments. Then, the shear test was performed. The Kruskal-Wallis and Spearman's Correlation tests were used for statistical evaluation of the data. Results: Significant differences were found between surface treatments and composite resins in terms of bond strength (p < 0.05). There is no correlation between the roughness and bond strength values. Conclusions: In bond strength, surface topography is more important than the numerical value of roughness. In the repair of composite restorations, methods that are already in clinical practice and more practical can be used instead of methods that require additional costs and devices.

A rapid ATR-FTIR spectroscopic method for classification of gelatin gummy candies in relation to the gelatin source.

Gelatin is widely used in gummy candies because of its unique functional properties. Generally, porcine and bovine gelatins are used in the food industry. FTIR-ATR combined with chemometrics analysis such as hierarchical cluster analysis (HCA) (OPUS Version 7.2 software), principal component analysis (PCA) (OPUS Version 7.2 software) and partial least squares-discriminant analysis (PLS-DA) (Matlab R2017b) were used for classification and discrimination of gelatin gummy candies related to their gelatin source. The spectral region between 1734 and 1528 cm-1 was selected for chemometric analysis. The potential of FTIR spectroscopy for determination of bovine and porcine source in gummy candies was examined and validated by a real-time polymerase chain reaction (PCR) method. Twenty commercial samples were tested by developed ATR-FTIR methodology and RT-PCR technique, mutually confirming and supporting results were obtained. Gummy candies were classified and discriminated in relation to the bovine or porcine source of gelatin with 100% success without any sample preparation using FTIR-ATR technique.

Analysis of the Role of Physicians in the Cessation of Cigarette Smoking Based on Medical Specialization.

OBJECTIVE: Physicians do not adequately use their unique professional privilege to prevent patients from smoking. The aim of this study was to investigate the type and extent of advice given to patients by physicians of different medical specialties regarding smoking cessation. METHODS: In total, 317 volunteer physicians were included in this study. The participants rated their attitudes toward the smoking habits of their patients by completing a questionnaire. The approaches used to address the smoking habits of patients significantly differed among physicians working at polyclinics, clinics and emergency service departments (p<0.001). Physicians working at clinics exhibited the highest frequency of inquiring about the smoking habits of their patients, while physicians working at emergency service departments exhibited the lowest frequency. RESULTS: Physicians from different medical specialties significantly differed in their responses. Physicians specializing in lung diseases, thoracic surgery, and cardiology were more committed to preventing their patients from cigarette smoking. CONCLUSIONS: The role of physicians, particularly pulmonologists and thoracic surgeons, is critical in the fight against cigarette smoking. Promoting physician awareness of this subject is highly important in all other branches of medicine.

A survey of free glutamic acid in foods using a robust LC-MS/MS method.

An effective and simultaneous liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used with the aim of quantifying monosodium glutamate (MSG) in foodstuffs, such as chips, taste cubes, sauces and soups. The results were linear (R2 = 1), with very low LOD and LOQ values, 1.0 µg/kg, 5.0 µg/kg, respectively. Excellent repeatability and reproducibility were also achieved. This highly sensitive and robust LC-MS/MS technique was applied successfully for the detection and quantification of MSG in a wide variety of foodstuffs. MSG contents ranged from 0.01 g/100 g to 15.39 g/100 g in food samples. Importantly, determination of free glutamic acid in the daily diet could also prevent various side effects associated with consumption of excess free glutamic acid.

Detection of l-Cysteine in wheat flour by Raman microspectroscopy combined chemometrics of HCA and PCA.

l-Cysteine is deliberately added to various flour types since l-Cysteine has enabled favorable baking conditions such as low viscosity, increased elasticity and rise during baking. In Turkey, usage of l-Cysteine as a food additive isn't allowed in wheat flour according to the Turkish Food Codex Regulation on food additives. There is an urgent need for effective methods to detect l-Cysteine in wheat flour. In this study, for the first time, a new, rapid, effective, non-destructive and cost-effective method was developed for detection of l-Cysteine in wheat flour using Raman microscopy. Detection of l-Cysteine in wheat flour was accomplished successfully using Raman microscopy combined chemometrics of PCA (Principal Component Analysis) and HCA (Hierarchical Cluster Analysis). In this work, 500-2000cm-1 spectral range (fingerprint region) was determined to perform PCA and HCA analysis. l-Cysteine and l-Cystine were determined with detection limit of 0.125% (w/w) in different wheat flour samples.

Hidden Toxicity in Neonatal Intensive Care Units: Phthalate Exposure in Very Low Birth Weight Infants.

OBJECTIVE: To determine exposure to endocrine-disrupting phthalates in preterm infants in neonatal intensive care units (NICU). METHODS: Urine samples (n=151) from 36 preterm infants (<32 weeks of gestation and/or <1500 g of birth weight) were collected on the first 3 days of admission to the NICU and biweekly thereafter. Diethylhexyl phthalate contents of indwelling medical devices used in various procedures and the concentrations of phthalate metabolites in the urine samples were analyzed. The relationships between urinary excretion, exposure intensity, postnatal age and birth weight were examined. RESULTS: The mean gestational age and mean birth weight of the study infants were 28.9±1.5 weeks and 1024±262 g, respectively. Diethylhexyl phthalate was detected in umbilical catheters, endotracheal tubes, nasogastric tubes, and nasal cannula. Monoethylhydroxyhexyl phthalate (MEHHP) was the most frequently detected metabolite (81.4%); its concentration increased during the first 4 weeks and then started to decrease but never disappeared. Patients who did not need indwelling catheters (except nasogastric tubes) after 2 weeks were classified as group 1 and those who continued to have indwelling catheters as group 2. Although not of statistical significance, MEHHP levels decreased in group 1 but continued to stay high in group 2 (in the 4th week, group 1: 65.9 ng/mL and group 2: 255.3 ng/mL). Levels of MEHHP in the first urinary samples were significantly higher in infants with a birth weight <1000 g (<1000 g: 63.2±93.8 ng/mL, ≥1000 g: 10.9±22.9 ng/mL, p=0.001). CONCLUSION: Phthalate metabolites were detected even in the first urine samples of very low birth weight newborns. Phthalate levels were higher in the first weeks of intensive invasive procedures and in preterm infants with a birth weight less than 1000 g. MEHHP was the most frequently detected metabolite and could be a suitable biomarker for the detection of phthalate exposure in preterm infants.

Formaldehyde migration in aqueous extracts from paper and cardboard food packaging materials in Turkey.

Migration of formaldehyde to aqueous extracts from paper and cardboard food packaging materials was determined by an ultraviolet visible-spectrophotometric method at 410 nm. Intraday and interday precision of the method, expressed as coefficient of variation, varied between 1.5 to 4.4% and 7 to 8.8%, respectively. The limit of quantification was 0.28 mg kg(-1) for formaldehyde in aqueous extracts. The recovery of the method was over 90% for two different concentration levels in aqueous extracts. The method was applied to the migration of formaldehyde to aqueous extracts from 31 different paper and cardboard materials collected from the packaging sector, intended for food contact, such as tea filters, hot water filters, paper pouches and folding boxes. The results were between limit of detection 0.23 mg/kg and 40 mg kg(-1) and were evaluated according to the relevant directives.

Pulmonary Strongyloides stercoralis infection.

The 17-year-old male patient presented with fever, weakness, dyspnea and weight loss. His chest radiography demonstrated diffuse reticulonodular density, and high-resolution lung tomography indicated diffuse micronodules and prevalent ground-glass pattern. The findings were consistent with miliary involvement. The patient underwent examinations for rheumatology, immunology, cytology and infectious conditions. His immune system was normal and had no comorbidities or any history of immunosuppressive treatment. Strongyloides stercoralis larvae were noted upon direct inspection of the feces. Clinical and radiological improvement was achieved with albendazole 400 mg/day. This case is being presented since miliary involvement in the lungs caused by S. stercoralis infection in an individual with intact immune system is rare and difficult to diagnosis.

[Diagnostic value of pleural fluid and serum procalcitonin levels in the diagnosis of parapneumonic pleural effusion]. / Parapnömonik plevral efüzyon tanisinda plevral sivi ve serum prokalsitonin düzeylerinin tanisal degeri.

INTRODUCTION: To determine the diagnostic value of pleural fluid procalcitonin (PF-PCT) and serum PCT (S-PCT) levels in the diagnosis of parapneumonic pleural effusion (PPPE). MATERIALS AND METHODS: Sixty five inpatients with exudative pleural fluid were consecutively included in this prospective study. Biochemical (total protein, albumin, LDH, glucose, pH, PCT) studies were performed in concurrently obtained pleural fluid and venous blood samples, cytologic and microbiologic (acid-fast bacillus smear/culture, nonspecific bacterial Gram stain/culture, fungal culture) studies were performed in pleural fluid. The patients were grouped as PPPE (n= 33) and non-PPPE (n= 32) after the diagnoses were definitely established. RESULTS: A total of 65 patients (M/F: 38/27; age: 57.53 ± 18.46 years) with exudative pleural fluids were assessed. In the 33 with PPPEs, 6 simple PPPEs, 5 complicated PPPEs and 22 empyemas were determined whereas in the 32 non-PPPEs, 9 tuberculous, 10 malignant, 6 paramalignant, 5 non-specific effusions and 2 chylothoraces were determined. Compared with the non-PPPE group, more fever, pneumonic infiltrations and fluid loculation, higher sedimentation, leukocyte, fluid LDH besides lower fluid glucose, pH, albumin and protein together with lower serum LDH were determined in the PPPE group (p< 0.05). Higher PS-PCT (1.03 ± 1.27 vs. 0.06 ± 0.06 ng/mL) and S-PCT levels (0.90 ± 1.44 vs. 0.05 ± 0.02 ng/mL) were determined in the PPPE group (p= 0.000). In the PPPE group, PS-PCT and S-PCT showed positive correlation with each other while PS-PCT did with sedimentation, leukocyte, CURB-65 and serum LDH, and S-PCT did with sedimentation, CURB-65 and duration of hospitalization. ROC curve, a specificity of 96.9% and a sensitivity of 57.5% were determined for an optimal PS-PCT cut-off level (0.285 ng/mL), and a specificity of %96.9 and a sensitivity of %66.6 for an optimal S-PCT cut-off level (0.105 ng/mL) that could differentiate PPPE. CONCLUSION: PS/S-PCT levels were found to be highly efficient in excluding PPPE but not sufficiently reliable in the diagnosis of it. However, these findings should be reassessed in a larger group of cases that have not been given any antibiotic/anti-inflammatory treatment.

Validation of protein and potassium intakes assessed from 24 h recalls against levels estimated from 24 h urine samples in children and adolescents of Turkish descent living in Germany: results from the EVET! Study.

OBJECTIVE: Nutrition-related health problems such as obesity are frequent among children and adolescents of Turkish descent living in Germany, yet data on their dietary habits are scarce. One reason might be the lack of validated assessment tools for this target group. We therefore aimed to validate protein and K intakes from one 24 h recall against levels estimated from one 24 h urine sample in children and adolescents of Turkish descent living in Germany. DESIGN: Cross-sectional analyses comprised estimation of mean differences, Pearson correlation coefficients, cross-classifications and Bland-Altman plots to assess the agreement between the nutritional intake estimated from a single 24 h recall and a single 24 h urine sample collected on the previous day. SETTING: Dortmund, Germany. SUBJECTS: Data from forty-three study participants (aged 5-18 years; 26% overweight) with a traditional Turkish background were included. RESULTS: The 24 h recall significantly overestimated mean protein and K intake by 10·7 g/d (95% CI of mean difference: 0·6, 20·7 g/d) and 344 mg/d (95% CI 8, 680 mg/d), respectively. Correlations between intake estimates were r = 0·25 (P = 0·1) and 0·31 (P = 0·05). Both methods classified 70% and 69% of the participants into the same/adjacent quartile of protein and K intake and misclassified 7% and 7%, respectively, into the opposite quartile. Bland-Altman plots indicated a wide scattering of differences in both protein and K intake. CONCLUSIONS: Among children and adolescents of traditional Turkish descent living in Germany, one 24 h recall may only be valid for categorizing subjects into high, medium or low consumers.

Placental growth factor: a predictive marker for preeclampsia?

BACKGROUND: An imbalance between angiogenic and antiangiogenic factors plays a fundamental role in the pathogenesis of preeclampsia. Serum levels of placental growth factor (PLGF), a factor promoting angiogenesis, in patients with preeclampsia are significantly lower than in nonpreeclamptic pregnancies. This study was designed to answer the question whether the measurement of PLGF at the beginning of the second trimester might be a predictive factor for the appearance of preeclampsia. METHODS: Serum samples of 61 women were collected between 15 and 18 weeks of pregnancy. PLGF levels were measured using a human PLGF ELISA and correlated with the outcomes of pregnancy. RESULTS: 7 women (11.47%) developed preeclampsia during pregnancy. Their PLGF levels between 15 and 18 weeks of pregnancy were significantly lower (p < 0.001) compared to the nonpreeclamptic pregnancies. Using a PLGF level of 41.84 pg/ml as a cutoff, this test has a sensitivity of 0.87 and a specificity of 0.83. CONCLUSION: Women who will develop preeclampsia in the course of pregnancy already have a significantly lower expression of PLGF between 15 and 18 weeks of pregnancy compared to those who will not. This test offers new possibilities in the prediction of preeclampsia.

Altered angiogenesis in preeclampsia: evaluation of a new test system for measuring placental growth factor.

BACKGROUND: Decreased concentrations of the circulating angiogenic factors, free placental growth factor (PLGF) and free vascular endothelial growth factor (VEGF), and increased concentrations of the anti-angiogenic factor, soluble fms-like tyrosine kinase 1 (sFLT-1) have been observed during clinical preeclampsia. We established a new PLGF-ELISA kit for the measurement of PLGF in sera. In the present study, we demonstrated the assay characteristics by measurement of PLGF expression in normal and preeclamptic pregnancies as compared to an established research kit. METHODS: Blood samples were taken from 64 women with singleton uncomplicated pregnancies for longitudinal measurement of PLGF in the course of pregnancy. In 30 preeclamptic patients, serum levels of PLGF and sFLT-1 were measured by Human PLGF-ELISA and Human sVEGF R1 ELISA according to the described test principles. The assay characteristics of the new PLGF-ELISA were determined and the results were compared to those performed with an available research kit. RESULTS: The PLGF concentration in normal pregnancies showed a steady increase starting at the beginning of the second trimester with a peak at 28-32 weeks and a consistent decline thereafter. The preeclamptic pregnancies had significant lower serum concentrations of PLGF and significant higher serum concentrations of sFLT-1 as compared to the non-preeclamptic pregnancies. All the measured assay characteristics fulfilled the required specifications. Comparison of the values of the new PLGF-ELISA and the established research kit resulted in a correlation coefficient of 0.921. CONCLUSIONS: Our results support the hypothesis that an imbalance between factors promoting angiogenesis, such as PLGF, and factors antagonizing angiogenesis, such as sFLT-1, has a fundamental role in the pathogenesis of preeclampsia. The new established ELISA test can be considered reliable and it offers many advantages. As it is authorized for routine diagnostic testing, it may offer new possibilities in the prediction of preeclampsia in clinical routine.

Biosorption of Au (III) and Cu (II) from aqueous solution by a non-living Cetraria islandica (L.) Ach.

Biosorption of Au(III) and Cu(II) from dilute aqueous solutions was investigated by biomass of the non-living Cetraria islandica (L.) Ach. The removal and recovery of gold and copper were studied by applying batch technique. The experimental parameters such as the pH of the solution, contact time, the amount of Cetraria islandica (L.) Ach. (dried lichen), the concentration of metals on retention and eluents kind and amount have been investigated. Au(III) and Cu(II) were adsorbed on the dried lichen at pH 3 and pH 8, respectively. Quantitative retention (> or = 90%) was obtained within 60 minutes for metals. Maximum capacity of 1.0 g of dried lichen for biosorption of Au(III) and Cu(II) were found as 7.4 mg of Au(III) and 19.2 mg of Cu(II). It was seen that the adsorption equilibrium data conformed well to the Langmuir model and Freundlich equation for Au(III) and only Freundlich equation for Cu(II). The method proposed in this study was applied to spiked mineral water analysis and metals adsorbed on the lichens were quantitatively (> or = 90%) recovered from mineral water samples by using 0.5 mol L(-1) HCl.