Does vitamin D level have an effect on COVID-19 positivity and COVID-19 related mortality? A retrospective study.

OBJECTIVE: To explore the possible relationship between vitamin D and coronavirus disease-2019 in an urban population known to have relatively low vitamin D levels. METHODS: The retrospective study was conducted in Bursa, Turkey, and comprised data of 30 family health centers from March 1 to December 15, 2020, related to diagnosed inpatients of coronovairus disease-2019. The diagnosis was based on polymerase chain reaction test for severe acute respiratory syndrome coronavirus-2 infection. Vitamin D levels of these patients were obtained from previous records and compared with those without polymerase chain reaction positivity. Vitamin D levels of positive patients who survived were compared with those who died of coronavirus disease-2019. Data was analysed using SPSS 21. RESULTS: Of the 2,105 patients whose data was retrieved, 212(10%) were positive for coronavirus disease-2019, while 1,893(90%) were negative. Among the positive patients, 89(42%) were men and 123(58%) were women. The overall median age was 45 years (Q1-Q3(Q1: first quartile, Q3: third quartile): 35-56 years). Vitamin D level was not significantly different between the positive and negative patients (p>0.05). Among the positive patients, 2(0.9%) patients did not have new admissions to the designated centers and their data was excluded, 206(97.2%) survived and 4(1.9%) died. There was no significant difference in vitamin D levels between those who survived and those who died (p>0.05). CONCLUSIONS: There was no significant relationship found between vitamin D levels and coronavirus disease-2019 infection and related deaths.

Seasonal influenza vaccine awareness and factors affecting vaccination in Turkish Society.

Objective: Influenza vaccine reduces the burden of seasonal influenza and related complications. Potential vaccination barriers need to be identified to raise awareness and increase acceptance. We aimed to investigate the rates of seasonal influenza vaccination and the knowledge, opinions, and behaviours prevalent in Turkish society. Methods: The study among seven regions in Turkey was conducted from October-November 2018 in 28 family health centres, using a cross-sectional, descriptive design. The knowledge, opinions, and behaviours of participants regarding the influenza vaccine were obtained by family physicians through face-to-face interviews with participants. Results: A total of 3,492 people aged 10-97 years age range (median: 50 years) were included in the study. Over half of the participants (59.9%, n = 2093) were female. It was found that the percentage of participants who never received the influenza vaccine was 78.4%; only 13.4% were occasionally vaccinated, and 8.1% received regular annual vaccination. Influenza vaccination rates were higher in married people (p < 0.001), women (p = 0.005), patients with chronic lung and cardiovascular disease (p < 0.001), those over 65 years /nursing home residents (p < 0.001). Awareness of the vaccine's benefit was higher in the group at high risk of influenza (p < 0.001). Conclusion: The rate of regular vaccination against influenza every year was insufficient, at 8.1%. Individuals' insensitivity, insufficient knowledge, and attitudes toward influenza vaccination is a serious health problem for Turkish society. Barriers to influenza vaccination can be reduced by good communication between family physicians and their patients.

F approach algorithm in missing landmark problem / Aproximación al algoritmo F en punto de referencia perdido

SUMMARY: Missing data may occur in every scientific studies. Statistical shape analysis involves methods that use geometric information obtained from objects. The most important input to the use of geometric information in statistical shape analysis is landmarks. Missing data in shape analysis occurs when there is a loss of information about landmark cartesian coordinates. The aim of the study is to propose F approach algorithm for estimating missing landmark coordinates and compare the performance of F approach with generally accepted missing data estimation methods, EM algorithm, PCA based methods such as Bayesian PCA, Nonlinear Estimation by Iterative Partial Least Squares PCA, Inverse non-linear PCA, Probabilistic PCA and regression imputation methods. Landmark counts were taken as 3, 6, 9 and sample sizes were taken as 5, 10, 30, 50, 100 in the simulation study. The data are generated based on multivariate normal distribution with positively defined variance-covariance matrices from isotropic models. In simulation study three different simulation scenarios and simulation based real data are considered with 1000 repetations. The best and the most different result in the performance evaluation according to all sample sizes is the Min (F) criteria of the F approach algorithm proposed in the study. In case of three landmarks which is only the proposed F approach and regression assignment method can be applied, Min (F) criteria give best results.

RESUMEN: Los datos faltantes pueden ocurrir en todos los estudios científicos. El análisis estadístico de formas involucra métodos que utilizan información geométrica obtenida de objetos. La entrada más importante para el uso de información geométrica en el análisis estadístico de formas son los puntos de referencia. Los datos que faltan en el análisis de formas se producen cuando hay una pérdida de información sobre las coordenadas cartesianas históricas. El objetivo del estudio es proponer el algoritmo de enfoque F para estimar las coordenadas de puntos de referencia faltantes y comparar el rendimiento del enfoque F con métodos de estimación de datos faltantes generalmente aceptados, algoritmo EM, métodos basados en PCA como Bayesian PCA, Estimación no lineal por Iterative Partial Least Squares PCA, PCA no lineal inverso, PCA probabilístico y métodos de imputación de regresión. Los recuentos de puntos de referencia se tomaron como 3, 6, 9 y los tamaños de muestra se tomaron como 5, 10, 30, 50, 100 en el estudio de simulación. Los datos se generan en base a una distribución normal multivariada con matrices de varianza-covarianza definidas positivamente a partir de modelos isotrópicos. En el estudio de simulación se consideran tres escenarios de simulación diferentes y se consideran datos reales basados en simulación con 1000 repeticiones. El mejor y más diferente resultado en la evaluación del desempeño según todos los tamaños de muestra es el criterio Min (F) del algoritmo de enfoque F propuesto en el estudio. En el caso de tres puntos de referencia, que es solo el enfoque F propuesto y se puede aplicar el método de asignación de regresión, los criterios Min (F) dan mejores resultados.

Can PET/CT be used more effectively in pleural effusion evaluation?

PURPOSE: Sometimes, characterization of pleural effusion (PE) can be challenging especially in patients whom invasive procedures/recurrent invasive procedures cannot be performed. The main purpose of the study is to answer this question, Can 18F-FDG-PET/CT contribute to reduction in the number of invasive procedures or patients undergoing to invasive procedures? Results may increase the effectiveness of patient management by facilitating clinical decision-making, especially in patients who cannot undergo invasive/recurrent invasive procedures. METHODS: Sixty-seven patients' 18F-FDG-PET/CT, pleural fluid cytologies (PFCs) and, if any, pleural biopsies were re-assessed. If patient's PFC/biopsy was malignant, effusion was considered as malignant. If two consecutive PFCs were negative in patients without biopsy, effusion was considered as benign. Characterization was based on consensus with baseline/follow-up 18F-FDG-PET/CT and clinical parameters in patients with one negative PFC (n = 6). RESULTS: None of the 18F-FDG-PET/CT parameters could characterize PE alone. However, if PE maximum standardized uptake value (SUVmax) > 1.3 or PE SUVmax/mean standardized uptake value of mediastinal blood pool (MBP SUVmean) > 1.2 was combined with at least one of the following, specificity and positive predictive value (PPV) were 100%, accuracy was around 90%. Diffuse-nodular/nodular pleural thickness, post-obstructive atelectasis, nodule/mass with SUVmax > 2.5 in lung, multiple pulmonary nodules. All 29 patients who had SUVmax > 1.3 together with at least one of the mentioned four parameters diagnosed malignant pleural effusion (MPE). However, sensitivity and negative predictive value (NPV) were still insufficient. CONCLUSION: Patients who have contraindications for invasive diagnostic methods, and meet the aforementioned criteria may be considered as MPE primarily. On the other hand, if PE SUVmax < 1.3 or PE SUVmax/MBP SUVmean < 1.2 with the negativity of the all four parameters mentioned above, it is difficult to say that this can be considered as benign pleural effusion (BPE) according to our results.

Evaluation of the prognostic role of NLR, LMR, PLR, and LCR ratio in COVID-19 patients.

We aimed to find the most useful biomarker by examining the prognostic effect of neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and lymphocyte-C reactive protein ratio (LCR) in patients with coronavirus disease 2019 (COVID-19). Three hundred and four patients diagnosed with COVID-19 infection in our hospital within 5 months (April-August 2020) were examined. Laboratory values and demographic findings of the patients were analyzed retrospectively. Thirty-six patients were diagnosed with severe cases. The ratio of NLR, LMR, PLR, and LCR of patients with severe and those with nonsevere clinical symptoms were statistically analyzed. The NLR and PLR ratios of those with severe clinical symptoms were significantly higher (p < 0.001), the LCR rate was significantly lower (p < 0.001), and there was no significant difference in the LMR rate (p = 0.199). When we examined other peripheral blood parameters, we found that CRP was high, lymphocyte and monocyte were low (p < 0.001), but neutrophil (p = 0.416) and platelet (p = 0.998) were not statistically different between the groups. According to the results, routine blood values are abnormal in patients with COVID-19. NLR, PLR, and LCR ratios can be used as more significant biomarkers than other values in predicting the prognosis of patients.

Morning blood pressure surge in early autosomal dominant polycystic kidney disease and its relation with left ventricular hypertrophy.

INTRODUCTION: The activation of the sympathetic nervous system, which usually leads to a swift surge in blood pressure in the morning hours (MBPS) may be the cause of left ventricular hypertrophy (LVH) and endothelial dysfunction (ED) in early autosomal dominant polycystic kidney disease (ADPKD) patients. We studied the association between MBPS and LVH in ADPKD patients with preserved renal functions. METHODS: Patients with ADPKD with preserved renal functions were enrolled. Prewaking MBPS was calculated using ambulatory blood pressure monitoring. The patients were categorized as MBPS (≥median) and non-MBPS (

Vitamin D status in the adult population of Bursa-Turkey.

BACKGROUND: Vitamin D, along with parathyroid hormone (PTH) and calcitonin, is an important hormone that affects bone and calcium metabolism. OBJECTIVES: To evaluate the vitamin D status and its seasonal variation in the adult population of Bursa. METHODS: Since there is not enough information about vitamin D levels, 25 OH vitamin D levels were analysed retrospectively from the records of 11,734 adult subjects (9142 women, 2592 men) admitted to 24 family health centres located in different districts of Bursa between 1 December 2017 and 30 November 2018. Some tests that can affect vitamin D levels, demographic features, and accompanying comorbidities were also evaluated. A face-to-face questionnaire was administered to subjects who were willing to answer (n = 2965). RESULTS: The mean serum vitamin D level was 16.6 ± 11.5 ng/mL in the entire population, 15.8 ± 11.7 ng/mL in women and 19.5 ± 9.9 ng/mL in men. The percentage of subjects with a vitamin D level <20 ng/mL was highest in March-May and lowest in the September-November period (80.7% and 69.9% for women, 77.5% and 32.9% for men, respectively). CONCLUSION: Vitamin D levels <20 ng/mL are more prominent in women, and decline in spring, in the adult population of Bursa. These results are meaningful for the population living in Bursa, Turkey and the northern European region.

General and abdominal obesity prevelances and their relations with metabolic syndrome components.

OBJECTIVE: To evaluate the frequency of obesity and its relation of metabolic syndrome. METHODS: The data from the records of the consecutive adult residents of Bursa province in Turkey who were admitted to the family health centers from the 1st January to the 31st December 2016 were evaluated retrospectively. The population size was 2901396 (N) and the sample size was at least n=17729. A total of 17812 participants (10939 females, 6873 males) were included in this retrospective observational study. Sociodemographic characteristics, diseases, used medication and smoking, height, weight, waist and hip circumferences (WaC and HC) were recorded from the files. RESULTS: The mean age of all subjects was 46.1 years, the mean BMI was 28.1 kg/m2 with a mean WaC of 91.3 cm, HC of 104.7 cm, WHR of 0.87. The prevalence of obesity in Bursa was found to be 32.2% (37.8% in females and 23.3% in males) according to BMI, 63.2% (69.7% in females, 52.9% in males) according to waist and hip circumferences. CONCLUSIONS: Preventive measures should be taken by health authorities to prevent the rapid increase in general and abdominal obesity that may lead to serious comorbidities.

Statistical errors in articles published in radiology journals.

PURPOSE: We aimed to evaluate articles in radiology journals indexed in the Science Citation Index or Science Citation Index Expanded in terms of statistical errors. By this means, we aim to contribute to the production of high quality scientific publications. METHODS: In this study, a total of 157 articles published in 2016-2017 in 20 radiology journals were reviewed randomly. Selected articles were evaluated for statistical errors regarding P values and statistical tests, and for errors in terminology and other errors related to interpretation. In addition, in order to examine whether the error rates of the articles published in the radiology journals differed according to the impact factor, the statistical errors were compared according to the impact factors of the journals. RESULTS: Of the 157 articles published in radiology journals, 10 had no statistical errors, while 147 had at least one statistical error. The most frequently encountered error was "errors in summarizing data" with a rate of 66%. This was followed by "incorrect representation of P values" with a rate of 42%. The least frequently encountered error was "statistical symbol errors" with a rate of 3%. There was no statistically significant difference according to impact factors. CONCLUSION: In conclusion, radiology journals, as do journals in different fields, include articles containing statistical errors. Even when the quality of the journal increases, there is no difference in these statistical error rates. In order to prevent statistical errors in manuscripts, there are responsibilities for both the researchers who conduct scientific studies and the editors who publish these studies in their journals. Researchers should have a basic statistical knowledge, and the editor must submit all manuscripts for a statistical review.

Three-dimensional analysis of craniofacial shape in obstructive sleep apnea syndrome using geometric morphometrics / Análisis tridimensional de la forma craneofacial en el síndrome de apnea obstructiva del sueño mediante morfometría geométrica

SUMMARY: Craniofacial morphology is a risk factor for obstructive sleep apnea syndrome. The general aim of this study was to investigate the craniofacial shape differences in adults with and without obstructive sleep apnea syndrome, using geometric morphometric methods. A descriptive study conducted in 106 adult Turkish subjects, consisting of 50 patients with OSAS diagnosed by polysomnography and 56 non-OSAS controls. Three dimensional craniofacial scanning processes were performed on patient subjects on the same day as the PSG. Twelve standard craniofacial landmarks were collected from each subject's 3D craniofacial scan. Geometric morphometric analysis was used to compare the craniofacial shape differences between the OSAS and non-OSAS control groups. No statistically significant difference in terms of general shape in face shapes was found between the OSAS group and control group. However, local significance differences were found. There were significant differences between the groups in some of the interlandmark distances: 11 % of the interlandmark distances were greater in OSAS patients, and 29 % were greater in controls. Greater measured distances in OSAS are concentrated in the nasal region. In the control group, the difference is not concentrated in a specific region. Given the relationship of craniofacial structural alterations and sleep disordered breathing, we hypothesized that inter-landmark distance measurements in the craniofacial anatomy of patients might be predictive of OSA.

RESUMEN: La morfología craneofacial es un factor de riesgo para el síndrome de apnea obstructiva del sueño. El objetivo general de este estudio fue investigar las diferencias de forma craneofacial en adultos con y sin síndrome de apnea obstructiva del sueño utilizando métodos morfométricos geométricos. Un estudio descriptivo realizado en 106 sujetos turcos adultos, de 50 pacientes con SAOS diagnosticados mediante polisomnografía y 56 controles no SAOS. El proceso de escaneo craneofacial tridimensional se realizó en pacientes sujetos el mismo día que el PSG. Se recogieron doce puntos de referencia craneofaciales estándar del escaneo craneofacial 3D de cada sujeto. Se usó el análisis morfométrico geométrico para comparar las diferencias de forma craneofacial entre los grupos de control SAOS y no SAOS. No se encontraron diferencias estadísticamente significativas en términos de forma general en las formas de la cara entre el grupo SAOS y el grupo control. Sin embargo, se encontraron diferencias de significación local. Hubo diferencias significativas entre los grupos en algunas de las distancias interlandmark: el 11 % de las distancias interlandmark fueron mayores en los pacientes con SAOS y el 29 % en los controles. Las mayores distancias medidas en SAOS se concentran en la región nasal. En el grupo de control, la diferencia no se concentra en una región específica. Dada la relación de las alteraciones estructurales craneofaciales y la alteración de la respiración durante el sueño, planteamos la hipótesis de que las mediciones de distancias inter-hito en la anatomía craneofacial de los pacientes podrían ser predictivas de la SAOS.

Periorbital Soft Tissue Anthropometric Analysis of Young Adults.

The authors aim to determine the periorbital soft tissue anthropometric norms for Turkish young adults for right and left eyes using a noninvasive two-dimensional photogrammetric analysis. Anthropometric measurements of the periorbital soft tissue were taken from 172 female and 56 male Turkish adults aged between 18 and 24 years. The periorbital soft tissue profiles (ocular and palpebral) for males and females were digitally analyzed using linear measurements made with standardized photographic records, taken in a natural head position. Statistically significant differences were found for ocular soft tissue measurements according to gender except inner intercanthal distance (P = 0.125) and right horizontal palpebral aperture (P = 0.240). Statistically significant differences were found for palpebral soft tissue measurements according to gender except right pretarsal skin height (P = 0.112) and left pretarsal skin height (P = 0.056). Results were compared with other ethnic groups. Normal periorbital soft tissue measurements are fundamental anatomical parameters utilized in ophthalmology, optometry, ophthalmic industry, oculoplastic surgery, clinical genetics, dermatocosmetology. Further, normal anthropometric measurements generate reference data for studies in craniofacial dysmorphology, oculoplastic surgery, dermatocosmetology, and comparative physical anthropology.

Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI.

BACKGROUND: Contrast induced nephropathy (CIN) has been proven to be a clinical condition related to adverse cardiovascular outcomes. In recent studies, the monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with CIN in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). METHODS: Consecutive STEMI patients treated with primary PCI were prospectively recruited. Subjects were categorized into two groups; as patients who developed CIN (CIN+) and patients who did not develop CIN (CIN-) during hospitalization. CIN was defined as either a 25% increase in serum creatinine from baseline or 44.20 µmol/L increase in absolute value, within 72 h of intravenous contrast administration. RESULTS: A total number of 209 patients were included in the study. Thirty-two patients developed CIN (15.3%). In the CIN (+) patients, monocytes were higher [1.02 (0.83-1.39) vs. 0.69 (0.53-0.90) 109/L, p<0.01] and HDL cholesterol levels were lower [0.88 (0.78-1.01) vs. 0.98 (0.88-1.14) mmol/L, p<0.01]. In addition, MHR was significantly higher in the CIN (+) group [1.16 (0.89-2.16) vs. 0.72 (0.53-0.95) 109/mmol, p<0.01]. In multivariate logistic regression analysis, MHR, Mehran score, AGEF score and CV/eGFR were independently correlated with CIN. CONCLUSIONS: Higher MHR levels may predict CIN development after primary PCI in STEMI patients.

Association of MDR1, CYP2D6, and CYP2C19 gene polymorphisms with prophylactic migraine treatment response.

Prophylactic therapy response varies in migraine patients. The present study investigated the relationship between the resistance to the drugs commonly used in prophylactic therapy and the possible polymorphic variants of proteins involved in the metabolism of these drugs. Migraine patients with the MDR1 3435TT genotype exhibited a better treatment response to topiramate than migraine patients with the CC and CT genotypes (p=0.020). The MDR1 C3435T polymorphism was also found to be a higher risk factor for topiramate treatment failure in a comparison of the number of days with migraine (ß2=1.152, p=0.015). However, there was no significant relationship between the treatment response to topiramate and either the CYP2D6 or CYP2C19 polymorphism, and there were no significant correlations between the treatment responses to amitriptyline, propranolol, and valproic acid and the MDR1, CYP2D6 and CYP2C19 gene polymorphisms. This is the first study to investigate the effect of the polymorphic variants on prophylactic therapy response in migraine patients.