How does neurokinin 3 receptor agonism affect pathological and cognitive impairments in an Alzheimer's disease-like rat model?

Alzheimer's disease (AD) is accepted as a form of progressive dementia. Cholinergic systems are commonly affected in AD. Neurokinin 3 receptor (NK3R) is involved in learning memory-related processes. It is known that the activation of NK3R affects the release of many neurotransmitters. The aim of this project was to investigate the effects of NK3R agonist senktide administration on neurobehavioral mechanisms in the experimental AD-like rat model. 50 male Wistar albino rats were divided into Control (C), AD, Control + NK3R agonist (CS), AD + NK3R agonist (ADS), AD + NK3Ragonist + antagonist groups (ADSO). We designed AD-like model by intrahippocampal administration of Aß1-42. After NK3R agonist + antagonist injections, open field (OF), Morris water maze (MWM) tests were applied. Cholinergic mechanism analysis from hippocampus-cortex tissues was performed by ELISA and catecholamine analysis from brain stem tissue were performed by HPLC method. The transitions from edge to center, rearing, grooming parameters were found to be reduced in final values of OF. While the group-time interaction was significant in the OF test findings, there was no significant difference between the groups. In MWM test, ADS group showed a learning level close to control group and animals in AD and ADSO groups could not learn target quadrant in MWM test. The brain stem NA and DA concentrations were not statistically significant. Hippocampal AChE-ChAT levels were supported by positive effects of senktide on learning via the cholinergic mechanisms. As a result, NK3R agonists were found to be effective in improving cognitive functions in rats with AD pathology. In the experimental AD model, positive effects of NK3R on learning memory may be mediated by cholinergic mechanisms.

Evaluation of rhomboid intercostal and subserratus plane block under direct vision for postoperative analgesia in thoracic surgeries: a prospective, randomized controlled trial.

OBJECTIVES: This study is designed to evaluate the efficacy of rhomboid intercostal and subserratus plane (RISS) block under the surgeon's direct vision for providing postoperative pain relief after thoracic surgeries. METHODS: Forty patients who underwent thoracotomy were prospectively recruited and randomly assigned to group R (intravenous patient-controlled analgesia + continued RISS block; n = 20) and group C (intravenous patient-controlled analgesia; n = 20). Numeric rating scale at rest and cough, at post-anaesthetic care unit, 1, 2, 6, 9, 12, 24 and 48 h, was used as the primary outcome measure. Secondary outcome measures were the amount of tramadol consumption, the number of patients required rescue analgesia, the occurrence of postoperative adverse effects, pulmonary functions and the overall satisfaction with pain management. RESULTS: Numeric rating scale scores both at rest and during coughing were significantly lower in group R than in group C at all time intervals (P < 0.001 in each). Tramadol consumption at 24 and 48 h was significantly lower in the group R block than in group C (P < 0.001 for each). None of the patients in group R requires rescue analgesia. The incidence of nausea and vomiting was similar among the groups. Compared with group C, change in lung function from baseline levels was significantly less in group R (P = 0.047 and P = 0.04 for FEV1 and FVC, respectively). The satisfaction scores in group R were significantly higher than that in group C (P < 0.001). CONCLUSIONS: Continuous RISS block improved postoperative outcomes of thoracic surgery in terms of reduced postoperative pain scores, sparing opioid consumption, pulmonary function and patient satisfaction.

Development and Validation of a Turkish Version of Obstetric Quality of Recovery-10.

OBJECTIVE: The 10-item Obstetric Quality-of-Recovery 10 scale is a validated patient-reported outcome questionnaire that measures the quality of recovery following delivery. This study aims to develop a Turkish version of the Obstetric Quality of Recovery 10 to evaluate its validity, reliability, and clinical feasibility. METHODS: Term parturients who underwent vaginal delivery or elective caesarean delivery were asked to complete a Turkish version of Obstetric Quality-of-Recovery 10 scoring tool and EuroQol 5-dimension 3L scores (including a global health visual analogue scale) 24 hours after delivery. To validate the Obstetric Quality of Recovery 10-Turkish, we assessed validity, reliability, and clinical feasibility and compared it with the EQ-5D-3L questionnaires. RESULTS: One hundred parturients completed the questionnaire in 24 hours (100% response rate). Obstetric Quality of Recovery 10-Turkish correlated highly with EQ-5D-3L score (r=-0.611) and global health visual analogue scale score (r = 0.652) at 24 hours and discriminated well between good versus poor recovery (global health visual analogue scale score ≥70 vs <70; median interquartile range were 86 [80-90] and 68 [59-75] (P < .001), respectively). Scores were similar for caesarean and vaginal deliveries, 83 (76-89) and 82.5 (69-90), respectively (P = .5). Twenty-four-hour Obstetric Quality of Recovery 10-Turkish scores did not correlate with any baseline demographic and clinical data parameters. Internal consistency was good (Cronbach's alpha=0.87 and inter-item correlation=0.41), and split-half reliability was very good (Spearman-Brown prophesy reliability estimate=0.86). Test-retest reliability was excellent (intra-class correlation coefficient=0.99). No floor or ceiling effects were demonstrated. CONCLUSION: The Obstetric Quality of Recovery 10-Turkish is a valid, reliable, and clinically feasible measure of inpatient postpartum recovery following caesarean and vaginal delivery modes.

Abnormal quantitative pupillary light responses following COVID-19.

PURPOSE: To characterize alterations in pupillary light reflex responses in subjects following coronavirus disease 2019 (COVID-19), especially those with long-COVID. METHODS: Thirty-five subjects with previous COVID-19 and 30 healthy control participants were enrolled in this cross-sectional comparative study. An infrared dynamic pupillometry system (MonPack One; Metrovision, France) was used to quantify pupillary light responses. The National Institute for Health and Care Excellence (NICE) long-COVID questionnaire was used to identify persisting symptoms at least 4 weeks after acute COVID-19. RESULTS: The median time after the diagnosis of acute COVID-19 was 4.0 (2.0-5.0) months. There was an increase in the latency of pupil contraction (P = 0.001) and a reduction in the duration of pupil contraction (P = 0.039) in post-COVID-19 subjects compared to healthy controls. No significant differences were observed in the initial pupil diameter, amplitude and velocity of pupil contraction or latency, velocity and duration of pupil dilation. Long-COVID was present in 25/35 (71%) subjects and their duration of pupil contraction was reduced compared to subjects without long-COVID (P = 0.009). The NICE long-COVID questionnaire total score (ρ = - 0.507; P = 0.002) and neurological score (ρ = - 0.412; P = 0.014) correlated with the duration of pupil contraction and the total score correlated with the latency of dilation (ρ = - 0.352; P = 0.038). CONCLUSION: Dynamic pupillometry reveals significant alterations in contractile pupillary light responses, indicative of parasympathetic dysfunction after COVID-19.

Effects of Combined Sertraline and Magnesium in Rat Atrium.

The objective of this study is to determine the synergistic effects of an antioxidant ion Mg+2, combined with selective serotonin reuptake inhibitor sertraline, in treatment or prevention of major depression and regulation of inotropic effect in the early postoperative period. Adult male 40 Wistar albino rats were randomly divided into 6 groups. Three to 4-mm long atrium strips were placed in organ bath, tension was adjusted to 2 g. Isometric contractions were induced with 10-3 M adrenaline. Group 1 was the control group, cumulative sertraline was given to group 2, cumulative MgSO4 to group 3, combined cumulative sertraline and MgSO4 to group 4, intraperitoneal sertraline injection for 29 days to group 5, and intraperitoneal MgSO4 injection for 14 days to group 6. Changes in weight, tensions, bleeding/clotting time, and biochemical findings were evaluated statistically. Isometric tension relationship between groups 1 and 3 was statistically significant after 4 mmol/L MgSO4 (p < 0.05). A rapid inhibition of contraction was observed in group 4. Inhibition of spontaneous contractions of groups 5 and 6 was found to be statistically significant at close values, p < 0.05. When blood clotting times were compared, a statistically marked decrease was found in group 6, p < 0.05. Compared to control group, there was a significant decrease in blood lipids in group 4. While LDH and CK-MB increased from plasma enzymes in groups 5 and 6, no significant change was observed in NT-proBNP. Combined treatment of high dose MgSO4 with antidepressants for pre or post-operative depression may cause fatal risks. Shortening clotting time may increase the risk of embolism and stroke. In order to reduce the risk of post-operative depression preoperatively, care should be taken when using magnesium combined with antidepressants and more studies are needed to be considered.

The development of the postpartum mobile support application and the effect of the application on mothers' anxiety and depression symptoms.

OBJECTIVE: The study aimed to develop the postpartum mobile support application to support postpartum mothers and to examine the effects of the use of mobile app on mothers' anxiety level and depression symptoms. RESEARCH DESIGN/SETTING: It is a parallel group pretest-posttest randomized controlled study carried out between July 2017 and February 2020. The mothers (62 in the experiment and 62 in the control group) who gave birth in full-term at a university hospital in Konya province in Turkey and who had healthy newborns constituted the study group. Data were collected using the Information Form, the STAI State and Continuity Anxiety Scale, and the Edinburgh Postpartum Depression Scale. Mixed pattern variance analysis (mixed anova), t test in dependent groups, t test and chi square analysis in independent groups were used to analyze the data. FINDINGS: Most of the mothers who used the application fed their baby only with breast milk and felt more sufficient about breastfeeding. The depression symptoms of mothers using the postpartum mobile support application was lower than that of the mothers in the control group; however, it was found that the application was not adequate alone to decrease anxiety levels and depression symptoms (p > 0.05). CONCLUSIONS: The postpartum mobile support application is an important and useful source in accessing reliable information; however, it was found to be insufficient to lower anxiety levels and prevent depression symptoms at the end of the six-week postpartum period.

Prostate incidentaloma on 18F-fluorodeoxyglucose positron emission tomography: Diagnostic value of volumetric positron emission tomography parameters.

OBJECTIVE: To evaluate whether volumetric PET parameters such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) contributed to maximum standardized uptake value (SUVmax) in predicting prostate carcinoma in the prostate incidentalomas (PI) in 18F-FDG PET/CT. MATERIALS AND METHODS: This retrospective study comprised 107 patients with PI of 4723 male patients who had undergone 18F-FDG PET/CT. SUVmax and volumetric PET parameters of PIs were assessed. MTV and TLG were acquired with each SUV threshold as 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0. RESULTS: The PI incidence was 2.3%, and the malignancy ratio of PI was 15.9%. According to further analysis results, 17 patients were in the malignant group, and 46 patients were in the benign group. Malignant PIs had higher SUVmax (10.6 vs. 6.4 and p<0.01), MTV (all p < 0.01) and TLG (all p < 0.01) than benign incidentalomas. All volumetric PET parameters had higher area under the curve (AUC) than SUVmax. SUVmax AUC was 0.835 [95% confidence interval (CI): 0.728-0.942]. MTV 2.5 and TLG 2.5 had the highest performance for predicting malignant PI.MTV2.5 AUC was 0.871 (95% CI: 0.775-0.968), and TLG2.5 AUC was 0.882 (95% CI: 0.797-0.967). Using TLG 2.5 greater than 29.8 as the cut-off point, the sensitivity and specificity for malignancy prediction were 94.1% and 82.6%, respectively. CONCLUSION: In this study, in which the effectiveness of volumetric parameters in the diagnosis of PI was evaluated for the first time, it was shown that they could potentially have clinical value along with SUVmax.

Risk and Prognostic Factors in Perinatal Hemorrhagic Stroke.

BACKGROUND: Perinatal stroke encompasses a heterogeneous group of focal neurological injuries early in brain development. In this study, we aimed to compare risk and prognostic factors in preterm and term infants with perinatal hemorrhagic stroke (PHS). PATIENTS AND METHODS: The study includes 66 infants with PHS. The infants were evaluated for demographic characteristics, fetal and maternal risk factors, perinatal events, clinical and neuroimaging findings, complications, and sequales. RESULTS: Of 66 infants with PHS, 44 (66.70%) were preterm and 22 (33.30%) were term infants. Primiparity, mucosal bleeding, and multiple lobes involvement were more common in term infants than preterm infants (P < 0.05); however, respiratory insufficiency, neonatal sepsis, perinatal asphyxia, respiratory distress syndrome, use of invasive mechanical ventilation, use of noninvasive mechanical ventilation, and prolonged hospitalization were more common in preterm infants than term infants (P < 0.05). Eight (12.12%) infants died during infancy period. Small for gestational age and mucosal bleeding were more common in infants who are dead than those alive (P < 0.05). Forty-two (63.63%) infants were followed. Cerebral palsy and/or epilepsy and/or hydrocephalus were diagnosed in 36 (85.72%) infants during follow-up. CONCLUSION: Our findings showed that PHS was much more common in preterm infants. Mucosal bleeding and multiple lobes involvement were more common in term infants. PHS has high morbidity and mortality rates. Small for gestational age and mucosal bleeding were more common in infants who are dead.

Comparative Evaluation of the Efficacy of Indirect Hemagglutination Test and Radiological Methods in the Pre-diagnosis of Cystic Echinococcosis

Objective: Cystic echinococcosis (CE) is a common public health concern in Turkey. In this study, we investigated the agreement between the results of radiological imaging methods and serological tests through a 5-year retrospective evaluation in patients admitted to a university hospital with a suspicion of CE so as to determine the frequency of CE in the study region. Methods: The indirect hemagglutination test (IHA) results of 1.046 patients obtained from various clinics with the suspicion of CE between January 2014 and December 2018 were retrospectively analysed. Of these, patients with at least one radiological imaging report in the system (938 patients) were included in the study. Radiological imaging findings and IHA test results were compared and examined. Results: Seropositivity was detected by IHA test in 143 (15.2%) of 938 patients included in the study. The CE findings were recorded in at least one radiological imaging report in 130 (90.9%) of 143 patients with positive IHA test. At least one of the radiological imaging reports suggested presence of CE in 362 (38.5%) of all the patients. Conclusion: Thus, serological test and radiological imaging methods should be used in combination for the diagnosis of CE.

Assessing volumetric changes in abdominal aortic aneurysms following endovascular repair.

OBJECTIVE: Volumetric changes in the aneurysm sac were evaluated following endovascular aortic repair (EVAR) in intact abdominal aortic aneurysm (AAA) patients who underwent EVAR. METHODS: Fifty-two patients, who underwent EVAR from 2015 to 2019, were analysed retrospectively. A total of 158 computed tomography angiography scans was examined by performing reconsctructive volumetric calculations. Total aneurysm volume (TAV), patent lumen volume (PLV) and thrombuscoated aneurysm wall volume (TCAWV) were calculated. The results obtained at six, 12 and 24 months postoperatively were compared with those of the pre-operative period. RESULTS: Mean TAV had regressed 7% by the sixth month (p = 0.1), 27% by the 12th month (p = 0.0003) and 19% by the 24th month (p = 0.0008). Mean TCAWV had increased 2% by the sixth month (p = 0.3), and regressed 26% by the 12th month (p = 0.3) and 14% by the 24th month (p = 0.8). Mean PLV had regressed by 20% by the sixth month (p = 0.008), 29% by the 12th month (p = 0.0002) and 26% by the 24th month (p = 0.0006). For each individual proximal, middle and distal measurement, regression was observed at six and 12 months; however, an increase was observed at 24 months compared to the previous follow ups. CONCLUSIONS: The expansion measurements of TAV in the 24th month support the doubts on the medium- to long-term results of EVAR. The largest regression in the aneurysm sac was observed in the distal portion, then in the proximal portion, and the least regression was observed in the middle section.

Are Kidney Donor Risk Index/Kidney Donor Profile Index Scores Predictor of Future Graft Function?

Kidney donor profile index (KDPI) is a method developed to assess donor kidney quality for cadaveric transplants. We investigated the relationship between kidney donor risk index (KDRI) and KDPI scores of cadaveric transplants in the last five years in our clinic and current graft conditions. Forty people (12 females, 28 males; mean age, 46.35 + 8.94 years), who underwent cadaveric transplantation between January 2013 and March 2018, were participated in this study. At the same time, the KPDI and KDRI scores of the donor's kidneys were calculated and then compared with that of the recipients' data. The mean KDRI value of donors was 1.11 ± 0.33 and the median KDPI value was 60.50%. KDRI/KDPI scores were found to be high in women (P = 0.021) and, when the posttransplant findings of the recipients were evaluated by bivariate correlation analysis KDRI/KDPI scores were positively correlated with the day when creatinine (Cr) values started to fall off spontaneously (r = 0.457, P = 0.003). It was observed that recipients who were transplanted from the donors with high KDRI/KDPI scores had higher Cr levels (P <0.01) and this relationship did not change over time (P = 0.115). When the donors were grouped as the standard-criteria donor and expanded-criteria donor (ECD); we found that the relationship between KDRI/KDPI, creatinine, and time was more significant in the ECD group (P = 0.04). KDRI/KDPI scores are closely related to graft outcomes especially in recipients that have kidneys from marginal donors. Therefore, evaluation of KDRI/KDPI scores might be required in marginal donors.

Comparison of Oral Sodium Bicarbonate and Solifenacin Treatment in Female Overactive Bladder Patients With Acidic Urine pH.

OBJECTIVE: In this study, we planned to compare the effects of oral sodium bicarbonate (NaHCO3) and anticholinergic (solifenacin) treatments in women with overactive bladder (OAB) and acidic urine pH values (<6). METHODS: According to the referral order of OAB patients, 8 g/d oral NaHCO3 (group 1) or 5 mg/d solifenacin succinate (group 2) was given to the patients. Both treatment regimens were applied one at a time for 12 weeks in total. Laboratory values, bladder diary, Patient Perception of Bladder Condition score, Patient Perception of Intensity of Urgency Scale, Overactive Bladder-Validated 8-Question Awareness Tool, and the King's Health Questionnaire (KHQ) scores before and after treatment were compared. RESULTS: A total of 59 patients were evaluated. Thirty-one patients were included in group 1, and 28 patients were included in group 2. No difference was detected in pretreatment and posttreatment laboratory values other than urine pH values in both groups. Whereas there was no difference in pretreatment urine pH values among the 2 groups, posttreatment urine pH values were significantly higher in group 1 compared with group 2 (P = 0.08, P < 0.001, respectively). There was a significant amelioration in the bladder diary parameters, symptom scores, and KHQ values measured after treatment in both groups. However, degree of amelioration in posttreatment outcomes was similar among the groups. CONCLUSIONS: It was demonstrated that urinary alkalization made with oral NaHCO3 in female OAB patients with acidic urine pH had a significantly positive effect on symptoms and symptom scores, and these results are similar to the results of solifenacin treatment.

Two-Dimensional Shear Wave Elastography in the Assessment of Salivary Gland Involvement in Primary Sjögren's Syndrome.

OBJECTIVES: The aim of this study was to investigate the diagnostic performance of two-dimensional (2D) shear wave elastography (SWE) in the assessment of salivary gland involvement in primary Sjögren's syndrome (pSS). METHODS: Fifty-three patients with pSS and 30 healthy volunteers were included. The echogenicity of all submandibular and parotid glands was evaluated with B-mode ultrasound, and their elasticity was assessed with 2D SWE. The mean and standard deviation of the shear wave speed and elasticity modes on 2D SWE were calculated. RESULTS: The mean shear wave speed and elasticity mode values for the submandibular and parotid glands were significantly higher in the patients with pSS (P < .05). The mean elasticity of the shear wave speed mode was best able to differentiate the parotid glands of patients with pSS from those of healthy volunteers at a cutoff value of 2.48 m/s, whereas the mean elasticity of the elasticity mode was best able to differentiate the submandibular glands of patients with pSS from those of healthy volunteers at a cutoff value of 21 kPa. CONCLUSIONS: Two-dimensional SWE is an effective technique for assessment of the parenchyma of the salivary glands in patients with pSS and predicts interstitial fibrosis and the severity of histologic damage.

Dynamic thiol/disulfide homeostasis as a novel indicator of oxidative stress in patients with urolithiasis.

Purpose: A dynamic thiol/disulfide balance is pivotal in organizing anti-oxidant defense, detoxification, apoptosis, and enzyme activities, as well as transcription and cellular signal-transfer mechanisms. The connection between urolithiasis and oxidant/antioxidant status, which can be assessed through thiol-disulfide homeostasis (TDH), has not yet been examined. In this study, we evaluated the effects of TDH on the formation, size, and location of stones by examining the associations between TDH parameters and urolithiasis. Materials and Methods: Patients with urolithiasis and healthy controls were recruited. The patients were divided into subgroups in terms of stone size (>15 mm or ≤15 mm) and stone location (nephrolithiasis or ureterolithiasis). TDH parameters were measured using a novel automatic and spectrophotometric method and compared statistically. Results: TDH parameters were different between the urolithiasis and control groups. TDH tended towards the disulfide side in the urolithiasis group. Stone size increased an average 0.14 mm with a 1 µmol/L increase in disulfide level and decreased an average 0.058 mm with a 1 µmol/L increase in native thiol level. Disulfide and native thiol levels were found to be different across patients with stone size >15 mm, ≤15 mm, and controls (p<0.001 and p<0.001, respectively). However, the nephrolithiasis and ureterolithiasis groups were similar in respect of TDH parameters. Conclusions: In this study, it was found that patients with urolithiasis displayed oxidative stress characterized by a TDH tendency towards the disulfide side, and an inadequate antioxidant response identified by a lower level of native thiol as compared with healthy controls.

Investigation of the relationship between ischemic stroke and endothelial nitric oxide synthase gene polymorphisms [G894T, intron 4 VNTR and T786C]

Background/aim: We aimed to investigate the associations between endothelial nitric oxide synthase(eNOS) gene polymorphisms [G894T (rs1799983)], intron 4 (27-bpTR) variable number tandem repeat (VNTR) and T786C (rs2070744), and ischemic stroke in the Anatolian population. Materials and methods: This case-control study included 112 patients with "stroke of undetermined etiology" and 160 controls. Real-time polymerase chain reaction (RT-PCR) analysis was used to analyze these polymorphisms. Between-group frequencies of alleles and genotypes were compared using binary logistic regression analysis. Results: No significant difference was observed between the two groups in terms of the genotype and allele distributions of the eNOS G894T (rs1799983) polymorphism (P > 0.05). The a alleles and the 4b/a and 4a/a genotypes of the intron 4 (27-bpTR) VNTR polymorphism had significantly higher frequencies in the patient group than in the control group (OR: 2.715, P < 0.001; OR: 3.396, P < 0.001; OR: 10.631, P = 0.016, respectively). On the contrary, the TC genotype and C alleles of the T786C (rs2070744) polymorphism had a significantly lower frequency in the patient group than in the control group (OR: 0.244, P < 0.001, OR: 0.605, P = 0.006, respectively) Conclusion: Our findings indicate that the eNOS G894T and T786C [rs2070744] polymorphisms are not associated with the risk of ischemic stroke, whereas the intron 4 [27-bpTR] VNTR may be a risk factor in the Anatolian population.

Analysis of Peripapillary Choroidal Thickness in Unilateral Amblyopia.

PURPOSE: To evaluate the peripapillary choroidal thickness (CT) in children with unilateral amblyopia using spectral-domain optical coherence tomography (SD-OCT). METHODS: One hundred and six eyes of 53 children with unilateral amblyopia and 20 eyes of 20 children with normal vision were involved in this study. Of the 53 children with unilateral amblyopia, 29 (54.7%) had hyperopic anisometropic amblyopia and 24 (45.3%) had strabismic amblyopia. Peripapillary CT was measured from 6 mm length radial B-scans at the optic nerve head using the enhanced depth imaging program of an SD-OCT (Heidelberg Engineering, Germany). Age, sex, refractive error, and best-corrected visual acuity were also recorded. RESULTS: The average peripapillary CT was greater in amblyopic eyes than in the fellow eyes of the children with amblyopia (P = 0.002), and control eyes (P < 0.001). There was no significant difference between the fellow eyes of children with amblyopia and the control eyes (P = 0.158). The average peripapillary CT was negatively correlated with axial length (AL) in amblyopic eyes (r = -0.381; P = 0.005) and fellow eyes (r = -0.392; P = 0.004) but not in control eyes (r = -0.232; P = 0.325). After adjustment for the possible effects of AL, the average peripapillary CT in amblyopic eyes was still greater than in fellow eyes (P = 0.014) and control eyes (P = 0.022). CONCLUSION: The peripapillary choroid of eyes with amblyopia was thicker than that of the fellow eyes and control eyes. No significant difference was observed between fellow eyes and control eyes.

Value of Cystatin C-Based e-GFR Measurements to Predict Long-Term Tenofovir Nephrotoxicity in Patients With Hepatitis B.

BACKGROUND: Cystatin C is a genuine marker for detecting minor reductions in estimated glomerular filtration rate (e-GFR). STUDY QUESTION: We aimed to investigate the efficiency of cystatin C levels in predicting nephrotoxicity due to antiviral therapy in patients with chronic hepatitis B virus infection. STUDY DESIGN: Seventy-six naive hepatitis B virus patients and 44 controls were enrolled in this prospective cohort study. MEASURES AND OUTCOMES: Serum cystatin C, phosphate and creatinine levels, and urinary albumin/creatinine ratios of all patients were measured at baseline, 3rd, 12th, and 24th months. Nephrotoxicity was determined according to the amount of change in creatinine level at the fourth year of treatment compared with baseline ([INCREMENT]Cr0-4). RESULTS: Mean age was 36.1 ± 9.2 years and 40 (52.2%) of patients were women. There was no significant difference between baseline values of tenofovir disoproxil fumarate and entecavir groups. Although the creatinine level at the fourth year of treatment was statistically nonsignificant compared with baseline in the entecavir group, it was significantly higher in the fourth year of tenofovir treatment compared with baseline (0.95 ± 0.27 mg/dL vs. 0.76 ± 0.16 mg/dL, P = 0.002). While the increase in [INCREMENT]Cr0-4 was ≥0.2 mg/dL in 43.2% of patients in the tenofovir group, this rate was 18.8% in the entecavir group. Diagnostic accuracy in identifying decreased renal function as area under the curve (AUC) was high for baseline serum cystatin C level; furthermore, the highest AUC was calculated for cystatin C plus creatinine-based e-GFR equation (AUC: 0.81, P < 0.001). CONCLUSIONS: Long-term tenofovir disoproxil fumarate nephrotoxicity can be predicted by serum cystatin C plus creatinine-based e-GFR measured before treatment.

Changes in Liver Tissue Trace Element Concentrations During Hepatitis B Viral Infection Treatment.

Approximately 350-400 million people in the world have Hbs Ag (hepatitis B virus surface antigen) positivity. In the international guidelines, the permanent suppression of replication in chronic hepatitis B virus (HBV) infection therapy is reported as the primary therapeutic goal. Trace elements play a key role in liver diseases. The aim of our study is to determine some trace element concentrations in the liver during HBV treatment periods. The measurement of 11 trace elements (manganese, lead, nickel, chromium, cadmium, iron, copper, zinc, silver, cobalt, and aluminum) was carried out by the method of inductively coupled plasma mass spectrometry in liver biopsy materials (before starting treatment and at the sixth month of the treatment period). There was an increase in zinc and copper concentrations in liver materials at the sixth month of treatment compared to the pre-treatment values (the median zinc value was 48.05 µg/g before treatment and 74.9 µg/g at 6 months after initial treatment, p = 0.035; median copper was 2.82 µg/g before treatment and 5.31 µg/g after 6 months, p = 0.002). General estimations indicated that zinc (p = 0.002), iron (p = 0.0244), copper (p = 0.0003), and aluminum (p = 0.0239) values may be effective in HAI (histological activity index) changes. Only iron levels could be at a very low level effective on the changes caused by fibrosis (p = 0.0002). Liver tissue zinc and copper levels increased in parallel with the improvement of inflammation in antiviral-treated HBV patients. In addition, the levels of zinc and copper in the liver tissue can be useful markers for liver tissue damage detection.

Human papillomavirus (HPV) subtypes and their relationships with cervical smear results in cervical cancer screening: a community-based study from the central Anatolia region of Turkey.

OBJECTIVE: Cervical cancer can be diagnosed early by cancer screening programs. The aim of this study was to evaluate the cervical smear test results of healthy women. METHODS: We enrolled 94,848 healthy women from 30-65 years of age in whom both HPV typing and a cervical smear test was performed between 2014 and 2017. RESULTS: HPV was detected in 3001 women (3.16%). The mean age was 42 ± 8.94 years old. Positive HPV types were HPV16; HPV16 and multiple infection; HPV31; HPV51; HPV39; HPV52; HPV56; HPV18; HPV68; HPV35; HPV18 and multiple infection; HPV58; HPV45; HPV59; HPV16, HPV18 and multiple infection; HPV16 and 18; and HPV33, in descending order. Cytology results were normal in 63.61%. We also identified atypical squamous cells of undetermined significance in 6.60%, atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion in 0.73%, low-grade squamous intraepithelial lesion in 10%, high-grade squamous intraepithelial lesion and atypical glandular cells in 0.53%, and adenocarcinoma in situ in 0.03%. In terms of HPV subtypes, abnormal smear results were divided into an HPV16, HPV18, and multiple infection group (25%), an HPV35 group (23.61%), an HPV 16 and multiple infection group (22%), and an HPV16-only group (21.85%). Most cases of HPV (39.02%) and abnormal cytology (43.04%) were detected between the ages of 30 and 40. CONCLUSIONS: This study is remarkable because it is a community-based study and includes a large population of healthy women to detect HPV prevalence, its subtype, and abnormal smear results.

Dynamic thiol disulphide homeostasis in operating theater personnel exposed to anesthetic gases.

BACKGROUND: The purpose of this study was to investigate the association between dynamic thiol/disulphide homeostasis and occupational exposure to volatile anesthetic gases in operating theater personnel. Decreased blood thiol levels and raised blood disulphide levels serve as biomarkers of oxidative stress. METHODS: We included 65 subjects occupationally exposed and 55 unexposed healthy medical professionals into the study. A novel method enabled separate measurements of components involved in dynamic thiol/disulphide homeostasis (native thiol, disulphide, and total thiol). To control for the potential confounding effect on oxidative stress of psychological symptoms potentially caused by occupational stress, we used scores obtained from four different anxiety and depression inventories. RESULTS: Mean ± standard deviation native thiol was found to be 433.35 ± 30.68 in the exposed group, lower than among controls, 446.61 ± 27.8 (P = 0.02). Disulphide in the exposed group was 15.78 ± 5.12, higher than among controls, 12.14 ± 5.33 (P < 0.001). After adjusting for anxiety and depression scores, age and gender, native thiol remained lower and disulphide higher in the exposed group (P = 0.008 and P < 0.001). CONCLUSION: Dynamic thiol/disulphide homeostasis in workers exposed to anesthetic gases was found to be disturbed after adjusting for the possible contribution of anxiety. We infer that this is due to the oxidative effect of exposure to anesthetic gases.