The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status.

BACKGROUND: Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. METHODS: The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5 ± 7 years (range 18-60 years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5 kg/m2 ), normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ) and obese (≥30 kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. RESULTS: Participants had mild (42.3%; n = 30), moderate (29.6%; n = 21) or severe IDD (28.2%; n = 20). They were underweight (12.7%; n = 9), normal weight (59.2%; n = 42) or overweight and/or obese (28.2%; n = 20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. CONCLUSIONS: While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.

The decreasing age of menarche in Turkey: global warming, socioeconomic development, and environmental factors.

OBJECTIVE: The age at menarche varies over time in line with the development level of society. The aim of the present study was to assess and compare secular trends of the age of menarche in Ankara, Turkey. PATIENTS AND METHODS: One thousand thirty-five patients who presented for regular gynecological control were examined retrospectively between 2011 and 2015. The patients were asked when they had experienced their first period. The data were evaluated in 10-year periods (<1964, 1965-1974, 1975-1984, and 1985-2000). The mean age at menarche presents trends that have changed over the years. RESULTS: The mean age at menarche decreased from 13.29 years in < 1964 to 13.24 years in 1965-1974, 13.20 years in 1975-1984, and 13.10 years in 1985-2000. When the < 1964 and 1985-2000 groups were compared, there was a two-fold increase in young age (≤ 11 years) at menarche. CONCLUSIONS: There is a continuing secular trend (a two-fold increase) in earlier age at menarche (i.e., ≤ 11 years). The effects of global warming and rising socioeconomic levels in Turkey may be implicated in the increase in earlier age at menarche.

The efficacy of bismuth quadruple therapy, sequential therapy, and hybrid therapy as a first-line regimen for Helicobacter pylori infection compared with standard triple therapy.

Background and Aim: To compare the effectiveness of first-line Helicobacter pylori eradication treatments as standard triple therapy (sTT), bismuth-containing quadruple therapy (BQT), sequential therapy (ST), and hybrid therapy (HT). Patients and Methods: 303 patients treated between July 2018 and June 2021 were studied. In this study, 76 patients in the sTT group, 78 patients in the BQT group, 75 patients in the ST group, and 74 patients in the HT group were randomly allocated. The diagnosis of H. pylori was made endoscopically. H. pylori stool antigen test was performed 4 weeks after finishing the treatment. Results: The mean age was 48.53 (13.48) in sTT, 49.04 (13.02) in BQT, 48.47 (14.54) in ST, and 47.45 (13.4) in HT. There was no significant age difference among the groups (P = 0.909). H. pylori eradication rate in intention-to-treat (ITT) analysis was 68.4% in sTT, 79.5% in BQT, 78.7% in ST, and 83.8% in HT. There was no significant difference between sTT, BQT, and ST regarding of eradication rate. The difference between HT and sTT was significant (P = 0.028). In the per-protocol (PP) analysis, the eradication rate was 74.3% in sTT, 88.6% in BQT, 86.8% in ST, and 92.5% in HT. There was a significant difference between sTT and BQT (P = 0.030) and sTT and HT (P = 0.004), whereas there was borderline significant difference between sTT and ST (P = 0.065). Conclusion: In terms of eradication, HT had the best rate, whereas the lowest rate was in the sTT treatment group. This study does not recommend using sTT because of the low eradication rates. This study recommends HT for overcoming antibiotic resistance and better results.

[TAp73α is Upregulated in the Most Common Human Cancers].

The transcription factor p73 is a member of the p53 tumor suppressor gene family and one of the key regulators of apoptosis. TP73 gene encodes two protein isoforms classes with diverse functions, TAp73 and DNp73, and TAp73 expression in tumor tissues is altered. Unlike the TP53 gene, TP73 is not mutated in cancers. Here, we sought to explore the expression of p73 isoforms across eight major cancer types using the publicly available data deposited at the GDC data portal and the TSVdb database. Our results showed that TAp73α is overexpressed in breast invasive carcinoma, stomach adenocarcinoma, lung squamous cell carcinoma, colon adenocarcinoma, and esophageal carcinoma tumors, whereas the expression of DNp73 isoforms is downregulated in breast invasive carcinoma (DNp73α,ß,γ), Prostate Adenocarcinoma (DNp73ß), Lung Adenocarcinoma (DNp73α), Lung Squamous Cell Carcinoma (DNp73α) tumors. In summary, this study revealed that TAp73α has higher expression than the DNp73 isoforms in several cancer types.

Anxiety and healthcare satisfaction of mothers with children hospitalized in the pediatric emergency service.

OBJECTIVES: This cross-sectional study was conducted to determine the anxiety and healthcare satisfaction levels of mothers with children hospitalized in the pediatric emergency service and the relationship between them. METHODS: The study sample comprised mothers (n = 316) with children hospitalized in the pediatric emergency service of a tertiary hospital in Turkey. Intsitutional and ethics committee approval was obtained, and data were collected using the Questionnare Form, State Anxiety Inventory (SAI), and PedsQL Healthcare Satisfaction Scale (PHSS). RESULTS: The SAI mean scores of mothers were moderate (45.30 ± 9.29) and their PHSS total mean scores were high (70.74 ± 23.80). In the study, there was a low-level negative correlation between the SAI mean scores of the mothers and the PHSS subscales and total scale mean scores (p < 0.05). We found a relationship between the PHSS mean scores of mothers and the SAI mean scores, maternal age, education level, and waiting time for the examination, explaining 13.5% of the scores on the PHSS scale (p < 0.05). CONCLUSION: In this study, the mothers had moderate anxiety and high healthcare satisfaction levels. Anxiety, educational level, and the waiting for an examination affected the healthcare satisfaction of mothers. The anxiety of mothers whose children are hospitalized in the pediatric emergency service should be reduced by conducting interventional studies.

Origin of the effects of optical spectrum and flow behaviour in determining the quality of dry fig, jujube, pomegranate, date palm and concentrated grape vinegars.

In this study, we focused on physical characterization and quality control of dry fig, jujube, pomegranate, date palm and concentrated grape vinegars using UV spectroscopy method and rheology technique. The optical spectra and flow behaviour of the vinegars were analysed in detail in the selected specific wavelength, shear rate and frequency ranges, respectively. It was determined that the peak values seen in the UV spectra of the vinegars were caused by the organic acid and phenolic compound concentration. The peak values in the UV spectra of the vinegars wavelength range of 190 nm to 240 nm and 250 nm to 300 nm were caused by the organic acid and phenolic compound concentration, respectively. In this context, it was predicted that concentrated grape vinegar, which has the highest absorbance value, has higher organic acid content and more antibacterial/antioxidant properties compared to the others. It is thought that the optical energy gaps of vinegars are related to the organic acid concentration and the release time. Flow properties of the vinegars were non-Newtonian thickening fluids (dilatant fluids) and compatible with the Power law model. The stable flow of the vinegars in the high shear rate region was interpreted as having a successful production process and being of good quality.

Quantitative assessment of temporomandibular disc and masseter muscle with shear wave elastography.

PURPOSE: To assess the normal stiffness values of temporomandibular joint disc (TMJ) and masseter muscle by shear wave elastography (SWE) in a healthy adult population. This may be helpful in diagnosing and understanding the mechanism of temporomandibular disorders (TMD). METHODS: This prospective study evaluated a total of 160 healthy adult volunteers (77 males, 83 females). The stiffness values of anterior, intermediate and posterior parts of the TMJ disc and masseter muscle were measured. Study cohort was classified into four groups based on age. Additionally, we investigated the changes in mean shear wave elasticity (kPa) and shear wave velocity(m/s) values of disc parts and masseter muscle in closed and open mouth positions, and the correlation of these SWE values with age and gender. RESULTS: Mean stiffness values of the disc were 37.02 ± 23.75 kPa and 3.28 ± 1.09 m/s in the anterior part, 30.47 ± 18.89 kPa and 2.97 ± 1.04 m/s in the intermediate part, 22.61 ± 13.97 kPa and 2.55 ± 0.88 m/s in the posterior part. Stiffness values showed significant decrease in the posterior part compared to the rest of the disc both in males and females. No significant differences in mean stiffness values of masseter muscle related to mouth position, age or gender. CONCLUSION: This study provides the normative quantitative elasticity values of disc and masseter muscle which could be a reference point for upcoming studies. Disc elasticity values are higher in women than men. Maybe this is one of the reason why TMD is more common in women. TMJ disc stiffness was significantly lower in the posterior part. SWE is a useful imaging method that can be used with routine ultrasonography in evaluation of the TMJ disc and masticatory muscles .

Effect of a bovine collagen matrix on tendon adhesions during the repair of rat Achilles tendon.

Adhesion after a tendon injury is one of the major problems following upper extremity surgery. In the present study, we evaluated a new material that is clinically usable as an adhesion barrier. Twenty-four male Wistar albino rats were used in the study. These rats (48 legs) were divided into three groups: sham, control, and experimental. No surgical intervention was performed in the sham group. After making a full-thickness cut through the right Achilles tendon, the tendon was repaired using the modified Kessler technique in the control group, while bovine collagen matrix was wrapped around the surgically repaired tendon using the modified Kessler technique in the experimental group. Two months after surgery, the operated and non-operated tendons were resected and analyzed through biomechanical, macroscopic, and histopathological examinations. The results of the biomechanical testing did not differ significantly between the control and experimental groups. Macroscopic examination of the adhesions revealed less adhesions in the experimental group but this difference was not statistically significant. Moreover, the results of the histopathological examination, which was performed based on five criteria, did not differ significantly between the two groups. Our study's results indicate that a bovine collagen matrix can be used to prevent tendon adhesion; however, larger studies are needed to verify these findings.

Investigation of the traditional organic vinegars by UV-VIS spectroscopy and rheology techniques.

Optical, rheological and metabolic properties of the apple, hawthorn, artichoke, grape, rosehip and blackberry organic vinegar produced by deep culture method (handmade traditional method) were analysed using UV-Vis spectroscopy and rheology techniques. Flow behaviours for all samples were analysed in the shear rate range of 10-3 to 103 1/s and in frequency range of 10-3 to 103rad/s, respectively. Absorption spectra for six organic vinegars was observed two peaks around 215 and 285nm due to the presence of phenolic compounds and organic acids such as acetic. The effects of optical transitions of organic molecules on the absorption coefficient values for vinegars were determined. Optical energy band gaps of all samples were found to be consistent with Planck's radiation approach known as Rayleigh-Jeans law and Tauc law. The rheological/flow properties of the all vinegars were found to be relevant with non-Newtonian flow behaviour and Ostwald-de Waele model. From the results of optical and rheological analysis, which determines the quantity and quality characteristics of all organic vinegars, it was concluded that these vinegars are in a level that people can drink easily.

Effect of packing pH values on the crumbliness of fresh Turkish White cheese.

A significant amount of Turkish White cheese is still produced in 1-kg cheese blocks and distributed to retail stores and farmers markets in 18-kg tin containers with brine. Portioning the cheese for the customer's desired weight requires a slicing process. The crumbs that occur during cutting or portioning are undesirable for customers and can cause economic loss for the business. In this study, our goal was to investigate the sliceability of White cheese that was manufactured at various final packing (i.e., packing with brine) pH values (5.3, 5.0, 4.7). For this purpose, we manufactured 4 batches of cheese at different times from high heat-treated milk (78°C, 8 min) and monitored the chemical and textural properties at 1, 2, 4, and 8 wk. Cheeses that were packed at pH 4.7 were harder compared with cheeses that were packed at pH 5.0 and 5.3. No correlation was observed between cheese-packing pH values and the size of the crumbs; however, there was a significant negative correlation between packing pH and crumb weight (i.e., decrease in cheese-packing pH increased the crumb weight). Cheeses packed at pH 5.0 and 5.3 exhibited increased slicing adhesiveness during storage. All cheese samples exhibited similar colloidal calcium phosphate levels and water-soluble nitrogen values during storage. This study showed that an increase in the packing pH of White cheese reduced the weight of crumbs that occurred during cutting. This study is the first study to investigate crumbs occurring with slicing in White cheese. This is also the first study in the literature that monitored the colloidal calcium phosphate content of Turkish White cheese.

Parotid elastography: a potential alternative to replace labial biopsy in classification of patients with primary Sjögren's syndrome?

BACKGROUND: There has been a substantial improvement in classifying patients with primary Sjögren's syndrome (pSS), with the new 2016 ACR/EULAR classification criteria. It was aimed to investigate the potential role of parotid elastography in the classification of patients with pSS, as well as the clinical diagnosis of those who do not otherwise fulfil the criteria. METHOD: This is a cross-sectional analysis of patients with pSS followed up in tertiary out-patient rheumatology clinic. Patients' medical records were retrospectively investigated whether or not clinically diagnosed pSS patients fulfil 2016 ACR/EULAR criteria sets. Elastographic evaluation of parotid and submandibular glands bilaterally was performed when presented for follow-up. Strain ratio, shear wave velocity and Pascal values of the glands were obtained. RESULTS: Clinical data on 179 patients with Sjögren's syndrome were investigated. Ninety-six patients with pSS and 30 gender and age-matched healthy controls were included in the study. Eighty-six percent of the clinically diagnosed patients satisfied the 2016 ACR /EULAR criteria and were considered 'criteria patients', and the remaining were considered 'non-criteria patients'. Both criteria and non-criteria patients had significantly higher parotid strain ratio and submandibular velocity compared with healthy controls (p < 0.001 and p < 0.001 for parotid strain ratio and p < 0.001 and p = 0.016 for submandibular velocity, respectively). Replacing labial gland biopsy findings with parotid strain ratio in the new classification criteria resulted in similar sensitivity and lower specificity, 91.6% and 80%, respectively. CONCLUSION: Parotid shear elastography is an easy and noninvasive method and might be a useful tool for the classification of patients with pSS, especially when labial gland biopsy is not feasible. Key Points • Salivary gland elastography (SGE) is a useful tool for the classification of patients with pSS. • SGE could be performed instead of labial biopsy without changing the diagnostic power of classification criteria.

Frequency, characteristics, and clinical determinants of 'prodrome' in familial Mediterranean fever patients.

Objective: Prodrome is defined by manifestations that precede a familial Mediterranean fever (FMF) attack and predict its emergence. We aimed to determine the frequency, characteristics, and clinical determinants of prodrome in patients with FMF.Method: This cross-sectional study was conducted in a tertiary rheumatology clinic. During the clinical interview, all patients completed a standardized questionnaire about the pre-attack period. Prodrome was defined as the presence of any recurrent pre-attack manifestation occurring at least 4 h before an attack. Patients were classified according to whether they had prodrome of any kind of attack.Results: The study enrolled 401 patients aged 37.7 ± 11.0 years (mean ± sd). Male gender, M694V/M694V, homozygous MEFV mutation, peritonitis, pleuritis, and arthritis were more frequent in prodrome-positive patients. Altogether, 141 patients (35.2%) had prodrome. Male gender and ever having attack types of peritonitis or arthritis were independent clinical determinants of prodrome [relative risk (95% confidence interval): 1.72 (1.07-2.76), p = 0.02; 4.27 (1.80-10.1), p = 0.001; 1.77 (1.04-3.04), p = 0.04, respectively]. Age, MEFV mutations, pleuritis, and erysipelas-like erythema were not clinical determinants.Conclusions: All FMF patients, particularly males and patients who had peritonitis or arthritis at any time, should be questioned about prodrome. Prodrome should be analysed in terms of elucidating the pathogenesis of FMF and as an opportunity for a secondary prevention strategy for impending attacks. This study may shed light on prodrome for future cytokine or drug studies with the purpose of developing new cost-effective treatment protocols irrespective of colchicine resistance.

The Pan-Cancer Landscape of Coamplification of the Tyrosine Kinases KIT, KDR, and PDGFRA.

PURPOSE: Amplifications of receptor tyrosine kinases (RTKS) are therapeutic targets in multiple tumor types (e.g. HER2 in breast cancer), and amplification of the chromosome 4 segment harboring the three RTKs KIT, PDGFRA, and KDR (4q12amp) may be similarly targetable. The presence of 4q12amp has been sporadically reported in small tumor specific series but a large-scale analysis is lacking. We assess the pan-cancer landscape of 4q12amp and provide early clinical support for the feasibility of targeting this amplicon. EXPERIMENTAL DESIGN: Tumor specimens from 132,872 patients with advanced cancer were assayed with hybrid capture based comprehensive genomic profiling which assays 186-315 genes for all classes of genomic alterations, including amplifications. Baseline demographic data were abstracted, and presence of 4q12amp was defined as 6 or more copies of KIT/KDR/PDGFRA. Concurrent alterations and treatment outcomes with matched therapies were explored in a subset of cases. RESULTS: Overall 0.65% of cases harbored 4q12amp at a median copy number of 10 (range 6-344). Among cancers with >100 cases in this series, glioblastomas, angiosarcomas, and osteosarcomas were enriched for 4q12amp at 4.7%, 4.8%, and 6.4%, respectively (all p < 0.001), giving an overall sarcoma (n = 6,885) incidence of 1.9%. Among 99 pulmonary adenocarcinoma cases harboring 4q12amp, 50 (50%) lacked any other known driver of NSLCC. Four index cases plus a previously reported case on treatment with empirical TKIs monotherapy had stable disease on average exceeding 20 months. CONCLUSION: We define 4q12amp as a significant event across the pan-cancer landscape, comparable to known pan-cancer targets such as NTRK and microsatellite instability, with notable enrichment in several cancers such as osteosarcoma where standard treatment is limited. The responses to available TKIs observed in index cases strongly suggest 4q12amp is a druggable oncogenic target across cancers that warrants a focused drug development strategy. IMPLICATIONS FOR PRACTICE: Coamplification of the receptor tyrosine kinases (rtks) KIT/KDR/PDGFRA (4q12amp) is present broadly across cancers (0.65%), with enrichment in osteosarcoma and gliomas. Evidence for this amplicon having an oncogenic role is the mutual exclusivity of 4q12amp to other known drivers in 50% of pulmonary adenocarcinoma cases. Furthermore, preliminary clinical evidence for driver status comes from four index cases of patients empirically treated with commercially available tyrosine kinase inhibitors with activity against KIT/KDR/PDGFRA who had stable disease for 20 months on average. The sum of these lines of evidence suggests further clinical and preclinical investigation of 4q12amp is warranted as the possible basis for a pan-cancer drug development strategy.

Is minimal invasive technique harmful in treatment of urethral stricture?

OBJECTIVE: Our goal was to evaluate the effect of previous history of direct vision internal urethrotomy (DVIU) on success rate of open urethroplasty in patients with bulbar urethral stricture. PATIENTS AND METHODS: We analyzed 133 patients who underwent open urethroplasty for bulbar urethral stricture between January 2008 and May 2017. Patients with penile and fossa navicularis stricture were excluded. We evaluated the effect of previous history of DVIU on success rate of open urethroplasty in patients with urethral stricture. Success of open urethroplasty was defined as disappear of voiding symptoms with maximum flow rate above 15 ml/s. The patients were followed for complications and outcome. RESULTS: Mean age was 54.05 ± 16.5 years. Mean length of stricture was 23.74 ± 10.23 mm. Mean follow-up was 39.77 ± 28.0 months. A total of 76 patients (57.1%) had no history of DVIU. On the contrary, 15.8% had history of DVIU once, 12% had twice, and 15.2% had more than twice. Success rate of open urethroplasty in patients who had no history of DVIU was 84%. However, this success rate was 71.4% in patients who had history of DVIU (P = 0.001). CONCLUSION: DVIU is easy, simple, and noninvasive technique in treatment of urethral stricture, so it is frequently used among urologists. However, it could not be an alternative technique to open urethroplasty. Internal urethrotomy can be used in some certain indications. Success rate of open urethroplasty can be affected by previous history of any endoscopic procedures.

Chronic inflammation in adult familial Mediterranean fever patients: underlying causes and association with amyloidosis.

Background: Chronic inflammation, as determined by persistently elevated acute-phase reactants in attack-free periods, can occasionally be observed in patients with familial Mediterranean fever (FMF) and is suggested to be a risk factor for the development of amyloidosis. We aimed to investigate the underlying causes of chronic inflammation in FMF patients and its association with amyloidosis in long-term follow-up. Method: Electronic medical records of FMF patients who had regular follow-up for ≥ 5 years in our cohort were utilized. As part of routine evaluation, detailed history, physical examination, and pertinent laboratory and radiographic investigations were performed in all patients to determine potential causes of elevated C-reactive protein (CRP) levels. Results: The study included 146 FMF patients who had no evidence of amyloidosis at baseline and had regular follow-up for ≥ 5 years. Thirty-seven patients (25.3%) were found to have chronic inflammation in the disease course. Twenty-five (67.5%) of them had either very frequent attacks or chronic manifestations of disease. In the entire study group, amyloidosis developed in five patients (3.42%) during the 5 year follow-up, four in the FMF with chronic inflammation group (10.8%), and only one of the 109 patients without chronic inflammation (odds ratio 13.09, 95% confidence interval 1.41-121.2). Conclusions: The results suggest that persistently high CRP levels during the attack-free periods may be a strong risk factor for the development of amyloidosis in patients with FMF. The vast majority of FMF patients with chronic inflammation had active FMF.

Increased incidence of spondyloarthropathies in patients with Takayasu arteritis: a systematic clinical survey.

OBJECTIVES: Takayasu arteritis and Spondyloarthritis are two distinct inflammatory diseases that affect the same age periods. Increasing number of reports on co-incident Takayasu arteritis-spondyloarthritis cases in literature raised the hypotheses about their association. The purpose of this study is to evaluate the incidence of spondyloarthropathy spectrum diseases in Takayasu arteritis patients. METHODS: Detailed clinical and demographic features of Takayasu arteritis patients were recorded and all were screened meticulously for the presence of spondyloarthropathy features following recommendations of Assessment of SpondyloArthritis international Society. Patients were questioned for inflammatory back pain, enthesitis, uveitis, inflammatory bowel disease, peripheral arthritis, and investigated accordingly with HLA-B27, plain X-rays and sacroiliac magnetic resonance imaging. RESULTS: A total of 69 Takayasu arteritis patients (65 female, 94.2%) were enrolled. After detailed investigation, 14 (20.3%) Takayasu arteritis patients fulfilled the Assessment of SpondyloArthritis international Society criteria for Spondyloarthropathy. Two of 14 (14.2%) spondyloarthropathy patients were positive for HLA-B27. Type 1 and type 2 Takayasu arteritis were more common in patients with diagnosis of both Takayasu arteritis and spondyloarthropathy than those without spondyloarthropathy. Most of patients with diagnosis of both these diseases required biologic therapies than patients with diagnosis of Takayasu arteritis alone (64.3% vs 29.1%, P = 0.014) due to refractory Takayasu arteritis. CONCLUSION: Our results suggest a significant association between Takayasu arteritis and spondyloarthropathy. Possible shared genetic or immunopathogenic processes may explain this association, which merits further investigations.

Induction of apoptosis by Centaurea nerimaniae extract in HeLa and MDA-MB-231 cells by a caspase-3 pathway.

We investigated the cytotoxic and apoptotic effects of a methanol extract of Centaurea nerimaniae, a plant endemic in Turkey, on HeLa and MDA-MB-231 cells. Eight concentrations of C. nerimaniae extract were applied to cells, and cytotoxic effects were measured using the xCELLigence system. The TUNEL assay was used to assess apoptotic cell death and immunohistochemistry was used to determine active caspase-3 using the effective cytotoxic doses of the extract. Doses of 1.42 mg/ml C. nerimaniae inhibited the growth of HeLa cells and 3.67 mg/ml C. nerimaniae inhibited the growth of MDA-MB-231 cells in a dose- and time-dependent manner. The apoptotic indexes for HeLa and MDA-MB-231 cells were increased significantly compared to control groups. Immunohistochemistry showed that the number of caspase-3 immunostained cells increased in the extract treatment groups for both HeLa and MDA-MB-231 cells. In the MDA-MB-231 cell line, caspase-3 immunostaining was observed in nuclei and/or cytoplasm in the extract treated group. Caspase-3 activation was greater in HeLa cells than in MDA-MB-231 cells. We found that the extract of C. nerimaniae had a strong antiproliferative effect and induced apoptosis via caspase-3; MDA-MB-231 cancer cells were more resistant than HeLa cells.