Fracture strength of endocrowns after thermomechanical aging.

This in-vitro study aimed to evaluate the fracture strength (FS; N) of composite, feldspathic, and glass-ceramic computer-aided design/computer-aided manufacturing (CAD/CAM) endocrowns after thermomechanical aging. Seventy non-carious human molars were randomly divided into seven groups, according to the CAD/CAM material used for endocrown fabrication. Intact molars without cavity preparations were used as control (n = 10). Following endodontic treatment, standardized endocrown cavities were prepared and endocrowns were fabricated using composite (Cerasmart270, CS and Grandio Blocs, GB), fired and milled zirconia-reinforced lithium silicate (Celtra Duo, CD), leucite-reinforced feldspar ceramic (LRF Initial, LRF), and feldspathic (Cerec Blocks, CE) materials which were luted with universal adhesive (Futurabond U; Voco) and dual-cure resin cement (Bifix QM). Following thermocycling for 20,000 cycles and 480,000 load cycles in a chewing simulator (CS-4.2, SD Mechatronik), FS was evaluated (Instron). Data were analyzed with one-way ANOVA and post hoc Tukey's tests (p < 0.05). FS was significantly influenced by the tested material (p = 0.00). CS had the highest FS, which was not significantly different from intact molars and fired CD (p > 0.05). There were no significant differences in FS between LRF, GB, and CD, which were significantly higher than CE. Most of the failure modes of CS, CD, and GB were repairable, whereas those of CE were irreparable. All the tested materials withstood clinically relevant axial forces. Composite endocrowns exhibited more favorable fracture pattern, whereas feldspathic and leucite-reinforced feldspar ceramic endocrowns exhibited mostly irreparable fractures.

Clinicopathological and Survival Characteristics of Mismatch Repair Status and PD-1 Expression in Serous Ovarian Cancer.

OBJECTIVE: To evaluate the clinicopathological characteristics of mismatch repair (MMR) deficiency and its clinical outcomes by performing immunohistochemistry (IHC) for MMR genes in the serous ovarian cancer (SOC) tumour sections. STUDY DESIGN: A retrospective case-control study. Place and Duration of the Study: Gynecology Department of Kanuni Sultan Süleyman Training and Research Hospital, and Department of Medical Oncology of Medipol University, between March 2001 and January 2020. METHODOLOGY: IHC was carried out for MLH1, MSH2, MSH6, and PMS2 on full-section slides from 127 SOCs to evaluate the MMR status. MMR-negative and MMR-low groups together were defined as MMR deficient and called microsatellite instability-high (MSI-H). The MSI status and expression of programmed cell death-1 (PD-1) were compared in SOCs with different MMR statuses. RESULTS: A significantly higher frequency of MMR-deficient SOCs was diagnosed at early stages compared with the patients in the MSS group (38.6% and 20.6%, respectively, p=0.022). The frequency of cases with PD-1 expression was significantly higher in the MSI-H group (76.2%) than in the MSS counterparts (58.8%, p=0.028). Patients in the MSI-H group had significantly longer DFS (25.6 months) and OS (not reached) than those in the MSS group (16 months and 48.9 months, p=0.039 and p=0.026, respectively). CONCLUSION: MSI-H SOCs were diagnosed at an earlier stage as compared to MMR proficient cases. The presence of PD-1 expression was significantly higher in cases presenting MMR deficiency compared with MMR-proficient cases. MSI status was significantly associated with DFS and OS. KEY WORDS: Serous ovarian cancer, Microsatellite instability, Mismatch repair deficiency.

Baseline serum vitamin A and vitamin C levels and their association with disease severity in COVID-19 patients.

AIM: We aimed to investigate the association between the serum concentrations of Vitamin A and Vitamin C and the severity of the COVID-19.  Methods: Fifty-three consecutive PCR (+) COVID-19 patients admitted to a dedicated ward were enrolled in this study. Blood samples for serum Vitamin A and C measurements were drawn from all participants upon admission. All subjects underwent thoracic CT imaging prior to hospitalization. CT severity score (CT-SS) was then calculated for determining the extent of pulmonary involvement. A group of healthy volunteers, in whom COVID-19 was ruled out, were assigned to the control group (n=26). These groups were compared by demographic features and serum vitamin A and C levels. The relationship between serum concentrations of these vitamins and pre-defined outcome measures, CT-SS and length of hospitalization (LOH), was also assessed.  Results: In COVID-19 patients, serum Vitamin A (ng/ml, 494±96 vs. 698±93; p<0.001) and Vitamin C (ng/ml, 2961 [1991-31718] vs. 3953 [1385-8779]; p=0.007) levels were significantly lower with respect to healthy controls. According to the results of correlation analyses, there was a significant negative association between Vitamin A level and outcome measures (LOH, r=-0.293; p=0.009 and CT-SS, r=-0.289; p=0.010). The negative correlations between Vitamin C level and those measures were even more prominent (LOH, r=-0.478; p<0.001 and CT-SS, r=-0.734: p<0.001). CONCLUSION: COVID-19 patients had lower baseline serum Vitamin A and Vitamin C levels as compared to healthy controls. In subjects with COVID-19, Vitamin A and Vitamin C levels were negatively correlated with CT-SS and LOH.

Two-year retrospective evaluation of monoshade universal composites in direct veneer and diastema closure restorations.

OBJECTIVES: The aim of this retrospective evaluation was to assess the short-term outcome of two monoshade universal resin composites with high chameleon effect in anterior direct veneer and diastema closure restorations, and to investigate the possible reasons for failure. MATERIAL AND METHODS: Patients subjected to veneer and diastema closure restorations with two monoshade universal resin composites (Essentia Universal Shade; EU, GC Corp., and Omnichroma; OC, Tokuyama) operated between January 2018 and March 2019 were selected for the present retrospective evaluation. A total of 159 composite restorations (78 veneers and 81 diastema closure restorations) performed by a single operator in 44 patients (mean age: 33.6) were included in the study. Two blinded and calibrated examiners performed 1- and 2-year assessments of the restorations with respect to FDI criteria, using medical/clinical history and dental photography records. Data were analyzed using Pearson Chi-square with Continuity Correction, Fisher's Exact tests, and Cox regression (a < 0.05). RESULTS: The cumulative overall survival rates of EU and OC restorations were 94.6% (97.3% for the first year) and 88.6% (95.3% for the first year), respectively, with no significant difference from each other (p = 0.316). The cumulative overall survival rates of direct veneer and diastema closure restoration types were 90.2% (95.1% for the first year) and 92.4% (97.4% for the first year), respectively, with no significant difference (p = 0.559). The reasons for failure were evaluated as fracture of the restoration, failure in esthetic anatomical form, and color mismatch. All the failed direct veneer restorations were due to fractures (FDI score of 5.4), whereas 5 of 6 failed diastema closure restorations were due to color mismatch (FDI score of 3.4). Regarding the composite materials, there were no significant differences between the success rates of the restoration types (p = 0.442 for EU, p = 1.000 for OC). With respect to the restoration types, there were also no significant differences between the success rates of the resin-based composites (p = 1.000 for direct veneer restorations and p = 0.228 for the diastema closure restorations). In addition, no significant difference was observed between male and female patients regarding the acceptable and unacceptable scores (p = 1.000). CONCLUSIONS: The 2-year clinical performance of the two monoshade universal composites in anterior veneer and diastema closure restorations were both considered successful and similar. Despite the lack of shade selection, both monoshade universal composites presented a successful color match. However, the diastema closure restorations might be more prone to color mismatch compared to the veneers over time, while veneer restorations presented more fractures than the diastema closure restorations. CLINICAL SIGNIFICANCE: Monoshade universal composites presented successful short-term clinical outcomes regarding both function and esthetics in anterior direct veneer and diastema closure restorations.

Comparison of enhanced recovery protocol with conventional care in patients undergoing urogynecological surgery.

OBJECTIVE: The impact of enhanced recovery after surgery (ERAS) protocol on postoperative outcomes after urogynecological surgery is yet to be a matter of investigation. This study sought to evaluate this issue by comparing the patients who had conventional or ERAS--guided perioperative care for several clinical end-points including ambulation, length of hospital stay (LOS), readmissions, and postoperative complications. MATERIALS AND METHODS: A total of 121 patients undergoing pelvic organ prolapse surgery were allocated to two study arms, ERAS protocol (Group E) or conventional care (Group C). Variables reflecting the restoration of appetite and bowel movements, bleeding events, other complications, LOS and readmissions were compared between the groups. RESULTS: The patients in Group C significantly received a more intensive intravenous fluid treatment compared to Group E (2,760 ± 656 vs. 1,045 ± 218 mL, P < 0.001). Time required for first flatus, first defecation, eating solid food, and ambulation (P < 0.001) were also longer in the former group of patients. Moreover, LOS was significantly reduced when the ERAS protocol was applied (2.5 ± 1.1 vs. 2.0 ± 0.6 days, P < 0.001). On the other hand, the two groups were similar with respect to the frequency of the postoperative complications, including surgical site infections, cardiovascular complications, non-specific abdominal pain, sub-ileus, blood loss and readmission rate. CONCLUSION: In our sample population, ERAS protocol led to early initiation of oral intake, early recovery of bowel function, early mobilization, and early discharge of patients without compromise in safety concerns after urogynecological surgery.

Push-out bond strength of fiber posts to irradiated and non-irradiated intraradicular dentin.

OBJECTIVES: The aim of this study is to evaluate the influence of ionizing radiotherapy on the resin-dentin interface in endodontically treated teeth restored with fiber posts using a dual-cure resin cement performed with the etch-and-rinse (ER) and self-etch (SE) approaches in terms of push-out bond strength (MPa), and to analyze the post/cement/dentin interface using scanning electron microscopy (SEM). MATERIALS AND METHODS: Seventy-six single-rooted human teeth were used and randomly assigned into two main groups (n = 38): one non-irradiated group (NoRad) and one group subjected to a cumulative radiation dose of 60 Gy (Rad). All root canals were instrumented and were further subdivided into two subgroups (n = 19) following the adhesive approach: ER (RadER; NoRadER) and SE (RadSE; NoRadSE) used for fiber post luting with the universal adhesive and dual cure resin cement. Each root was sectioned perpendicularly to its long axis and sections from the middle third of the roots were chosen for SEM analysis and push-out bond strength test. Two-way ANOVA with post hoc Tukey tests and a dummy variable linear regression analysis were used for data analysis. RESULTS: Regardless of the adhesive approach, push-out bond strength in irradiated teeth resulted in significantly lower values than non-irradiated teeth (p = 0.0001). There were no significant differences between the ER and SE approaches in non-irradiated teeth (p = 0.955), whereas the ER approach showed significantly higher bond strengths than the SE approach in irradiated teeth (p = 0.0001). CONCLUSIONS: Ionizing radiotherapy resulted in dentin structure disruption and negatively affected the push-out bond strength of fiber posts to intraradicular dentin. The reduction in bond strength was also more significant with the SE approach than with the ER approach. CLINICAL RELEVANCE: The alterations resulting from root dentin irradiation seem to influence adhesive systems bond strength to dentin, as these changes contribute to lower push-out bond strength in irradiated groups before fiber post luting. Thus, clinicians should prepare patients with a reasonable restorative treatment plan prior to radiotherapy and simultaneously initiate a preventive program during radiotherapy.

Pleth Variability Index-Based Goal-Directed Fluid Management in Patients Undergoing Elective Gynecologic Surgery.

Objectives: Data concerning the usefulness of pleth variability index (PVI)-based goal-directed fluid management (GDFM) in gynecologic surgery is limited.This study purposed to compare the impact of PVI-based GDFM to conventional fluid management (CFM) on intraoperative hemodynamics and lactate levels in subjects undergoing gynecologic surgery. Methods: This randomized and controlled trial was conducted on 70 patients undergoing elective gynecologic surgery. Subjects were randomly assigned to CFM or GDFM. Hemodynamic data and results of the arterial blood gas analysis, and total amount of the fluid infused were recorded throughout the surgery at 1-h intervals. Results: The amount of the total fluids was significantly higher in the CFM group compared to that of the GDFM group (p<0.001). Mean arterial pressure recorded at the 2nd h of the surgery was significantly lower in the CFM group compared to that of the GDFM group (p=0.047). While there were no significant differences between the baseline and the 2nd h lactate levels in the GDFM group, the lactate level significantly increased from baseline to the 2nd h in the CFM group (p=0.010). Conclusion: Implementation of PVI-based GDFM provides better intraoperative hemodynamic stability and lower lactate levels compared to the CFM in subjects undergoing gynecologic surgery.

Serum neutrophil gelatinase-associated lipocalin concentrations are significantly associated with the severity of COVID-19 in pregnant patients.

OBJECTIVES: To evaluate serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations of pregnant women complicated with coronavirus disease 2019 (COVID-19) and investigate its diagnostic value for the severity of COVID-19. METHODS: Of the 46 pregnant women with COVID-19 included in the study, we further classified these women into 2 subgroups: the non-severe COVID-19 group (n=25) and the severe COVID-19 group (n=21). RESULTS: Neutrophil gelatinase-associated lipocalin plasma concentrations were significantly higher in pregnant women complicated with severe COVID-19 (90 [53.1-207.7] ng/ml) compared to those from pregnant women with non-severe COVID-19 (51.8 [39.6-70.3] ng/ml) and healthy pregnant women (44.3 [32.2-54.1] ng/ml, p<0.001). Also, at a cutoff value of 72 ng/ml, NGAL predicted severe COVID-19 with a sensitivity rate of 57% and a specificity rate of 84%. Serum NGAL level (adjusted hazard ratio [aHR]=1.020, 95% confidence interval [CI]= [1.006-1.035], p=0.007), and D-dimer level (aHR=2.371, 95% CI= [1.085-5.181], p=0.030) were the variables that were revealed to be significantly associated with the disease severity. CONCLUSION: We demonstrated that NGAL was highly associated with COVID-19 severity. We consider that NGAL might be a useful biomarker to diagnose the disease severity in patients with COVID-19.

The Implication of Aquaporin-9 in the Pathogenesis of Preterm Premature Rupture of Membranes.

OBJECTIVE: This study aimed to detect aquaporin-9 (AQP9) concentrations in the serum of patients with preterm premature rupture of membranes (PPROM) and compare them with the healthy control group with intact membranes. MATERIAL AND METHODS: We conducted this prospective case-control study from March 2021 to August 2021. Of the 80 pregnant patients included in the study, we enrolled 42 singleton pregnant patients with PPROM as the study group and 43 healthy gestational age-, and body mass index (BMI)-matched healthy pregnant women with intact fetal membranes as the control group. We compared demographic and clinical characteristics, complete blood count and biochemical parameters, and serum AQP9 concentrations of the participants. We constructed an ROC curve to illustrate the sensitivity and specificity performance characteristics of AQP9 and calculated a cutoff value by using the Youden index. RESULTS: Maternal serum AQP-9 concentrations were significantly higher in patients with PPROM (804.46±195.63 pg/mL) compared to the healthy pregnant women in the control group (505.97±68.89 pg/mL, p<0.001). When we examine the area under the ROC curve (AUC), the AQP-9 value can be reflected as a statistically significant parameter for diagnosing PPROM. According to the Youden index, a 654.78 pg/mL cut-off value of AQP-9 can be utilized to diagnose PPROM with 80.5% sensitivity and 100% specificity. CONCLUSION: Maternal serum AQP9 concentrations were significantly higher in PPROM patients than healthy pregnant women with an intact membrane. We suggest that AQP9 might be an essential biomarker of the inflammatory process and energy homeostasis in PPROM.

Maternal and neonatal outcomes of expectantly managed pregnancies with previable preterm premature rupture of membranes.

PURPOSE: This study aimed to describe the maternal and fetal outcomes associated with expectant management following previable preterm premature rupture of membranes (PPROM) before 24 weeks of gestation. We also analyzed the risk estimates of potential confounders to clarify whether these variables are contributed to the risk of postnatal mortality among these neonates. METHODS: This retrospective cohort study included all pregnant patients who experienced previable PPROM before 24 weeks of gestation at a tertiary maternal-fetal medicine center. We used the neonatal data from birth until discharge. RESULTS: A total of 128 women were enrolled. The survival to discharge rate was 60.9%. The median latency period (80 vs. 20 days, respectively, p < 0.001) was significantly longer, the median gestational week at delivery (34 vs. 25 weeks, respectively, p < 0.001) and median birth weight (2100 vs. 710 g, p < 0.001) was significantly higher in the survivor group than the non-survivor group. Surviving neonates had significantly lower frequencies of anhydramnios at any time during the latency period than the non-survivor neonates (38.4% vs. 86.0%, respectively, p < 0.001). CONCLUSION: This study demonstrated an opposite correlation between the duration of latency period and gestational age at PPROM with earlier membrane rupture in pregnancies having a longer latency period, which additionally clarifies the higher gestational age at delivery. The antepartum factors that increased the possibility of postnatal mortality within our study included the gestational week at delivery, duration of the latency period, anhydramnios at any time during the latency period, and birth weight.

Abnormal liver function tests in pregnant patients with COVID-19 - a retrospective cohort study in a tertiary center.

OBJECTIVES: The current study aimed to describe the incidence of abnormal liver function tests (LFTs) in pregnant COVID-19 patients, explore the association between LFTs with current medication, and provide a reference for medical therapy of pregnant patients with COVID-19. MATERIAL AND METHODS: This retrospective single tertiary center cohort study included 122 pregnant patients with confirmed COVID-19 admitted and treated from April 1, 2020, to May 31, 2020. We defined abnormal LFTs as the elevation of the following liver enzymes in serum per our hospital's laboratory reference range standards: AST > 35 U/L, ALT > 35 U/L, and TBIL > 1.2 mg/dL. We evaluated patients for demographic and clinical features, laboratory parameters, medications, and hospital length of stay (LOS). RESULTS: Patients in this cohort had clinical presentations of fever (84.4%), dry cough (78.6%), and shortness of breathing (6.5%). In total, 17 (13.9%) patients had abnormal LFTs during hospitalization. Critically ill patients were three-fold higher in the abnormal LFTs group (11.8%) than in the normal LFTs group (3.8%, p = 0.16). The proportion of patients who used hydroxychloroquine and lopinavir/ritonavir were significantly higher in patients with abnormal LFTs (88.2% and 35.3%, respectively) than those with normal LFTs (62.9% and 15.2%, p = 0.04 and p = 0.04, respectively). The hospital length of stay (LOS) was significantly longer in the abnormal LFTs group (8.2 ± 5.8 days) than in the normal LFT group (6.0 ± 2.8 days, p = 0.02). CONCLUSIONS: SARS-CoV-2 may induce liver injury and the LFT abnormality was generally mild in pregnant patients with COVID-19. Abnormal LFTs are associated with prolonged hospital LOS. Drug use was the most crucial risk factor for liver injury during hospitalization. The use of lopinavir/ritonavir and hydroxychloroquine were significantly higher, and the course of treatment of these drugs was significantly longer in pregnant women with abnormal LFTs than the patients with normal LFTs. Therefore, pregnant women with COVID-19 who received antiviral treatment should be closely monitored for evaluating LFTs.

Combination therapy with azacitidine, etoposide, and cytarabine in the treatment of elderly acute myeloid leukemia patients: A single center experience.

AIMS: The prognosis of acute myeloid leukemia (AML) in elderly patients is worse due to age and comorbidities. Lately, monotherapy with hypomethylating agents like azacitidine (Aza) has been used to prolong overall survival (OS) in AML patients. Herein, we present a retrospective study investigating treatment responses and OS of Aza in combination with etoposide (Eto) and cytarabine (ARA-C) in elderly. MATERIALS AND METHODS: In this study, therapies and outcomes of 37 newly diagnosed AML patients, >60 years old, and ineligible for intensive chemotherapy were investigated retrospectively. Patients were grouped according to the treatments they received as follows - Group 1: low-dose conventional therapies as hydroxyurea, low-dose ARA-C, or best supportive care (n = 11); Group 2: Aza alone (n = 6); Group 3: Aza in combination with Eto and ARA-C (Aza + Eto + ARA-C, n = 20). RESULTS: It was found that an Aza + Eto + ARA-C combination therapy had significantly better overall response rates (P = 0.002). Combination group had significantly better OS than Group 1 (8 months vs. 1 month, P < 0.001), the difference between combination and monotherapy was not significant. The OS was also associated with age and performance status, but the difference was still statistically significant after adjustment for these factors, especially for patients with younger age and better performance. CONCLUSIONS: We concluded that combination therapy of Aza with Eto and ARA-C increases response rates, and prolong survival for this poor prognosed patient group. We believe that larger controlled studies investigating Aza combinations with other antileukemic drugs will contribute to the development of tolerable treatment protocols for elderly AML patients.

The Predictive Role of the Neutrophil/Lymphocyte Ratio in Survival with Multiple Myeloma: A Single Center Experience.

BACKGROUND: Recent studies have shown a positive correlation between tumor-related immune response markers and the poor outcome in solid tumors. In this study, we aimed to investigate the neutrophil/lymphocyte ratio (NLR) in multiple myeloma. To the best of our knowledge, this would be the second report concerning this topic. METHODS: We retrospectively reviewed the data for 52 multiple myeloma patients. The patients were grouped using the baseline NLR as NLR ≤ 1.72 and NLR > 1.72 using receiver operating characteristic analysis to determine a cut off. We compared the two groups in terms of both the known prognostic factors of the myeloma and the overall survival (OS). RESULTS: Our study showed that NLR is associated with C-reactive protein and ß2 microglobulin (P = 0.02 and P = 0.001, respectively). The patients with NLR > 1.72 had significantly worse stages, performance status, and kidney functions. The whole group's OS was estimated as 35.1 months while the patients with lower NLR had better OS when compared with those with NLR > 1.72 (42.75 and 26.14 months, respectively, P: 0.04). CONCLUSION: Neutrophil/lymphocyte ratio, which is associated with stage, performance status, and kidney functions, can be used in daily practice as a predictor for survival in multiple myeloma. Simply adding NLR to the routine charts may enrich our data for larger studies.

Comparative Evaluation of Common Comorbidity Scores and Freiburger Comorbidity Index as Prognostic Variables in a Real Life Multiple Myeloma Population.

Multiple myeloma (MM) is a disease of the geriatric population with a median age at diagnosis of 69 years but most clinicians consider performance status and comorbidities rather than chronological age in determining prognosis and treatment. The purpose of this study was to assess whether and which comorbidity indices predict survival in a real life population of MM. We calculated Charlson Comorbidity Index (CCI), age combined Charlson index (CCI-age), Hematopoietic cell transplantation-specific comorbidity index (HCT-SCI) and Freiburger comorbidity index (FCI) retrospectively for 66 MM patients and compared their impact on treatment responses and overall survival (OS). Treatment response was significantly worse in groups with high CCI, CCI-age, HCT-SCI scales (p < 0.05), but FCI's effect on treatment response was not significant. However, while no significant relationship was determined between other comorbidity indices with OS, it was related only with FCI-CI (p = 0.006). FCI, developed in this patient group, was the only prognostic index with a significant effect on OS in the evaluation of comorbidities in MM patients with different scores, but its relationship to treatment responses was not significant contrary to other indices. While this small patient group gave us hope regarding the use of FCI in practice, multi-center studies are still required.

Does preeclampsia have any adverse effect on fetal heart?

OBJECTIVE: To determine whether preeclampsia causes fetal cardiac cell damage by assessing umbilical artery NT-proBNP, cardiac troponin I and homocysteine. METHODS: A cross-sectional study with 73 fetuses between 26 and 40 weeks of gestation was performed. Thirty-three healthy mothers' fetuses were control group (Group I). While 12 mildly pre-eclamptic mothers' fetuses constituted Group II, 28 fetuses of severe pre-eclamptic mothers were Group III. RESULTS: Umbilical cord mean NT-proBNP levels of Group I, II and III are 520.8 ± 404.5 pg/ml; 664.2 ± 215.9 pg/ml; and 1932.8 ± 2979.5 pg/ml, respectively (p = 0.0001). The number of neonates with NT-proBNP > 500 pg/mL that indicates severe cardiac damage is higher in Group III (p = 0.001). The mean homocysteine levels are also statistically significantly higher in Group III. Cardiac troponin I levels are not different between the groups (p = 0.46). CONCLUSION: Increased NT-proBNP and homocysteine might not only indicate some degree of in-utero cardiac cell damage but also feto-placental endothelial injury in the fetuses of severe pre-eclamptic mothers. Our finding that shows no evidence of correlation between cardiac troponin I levels with cell damage and endothelial injury requires further research.

Differentiations of chitin content and surface morphologies of chitins extracted from male and female grasshopper species.

In this study, we used Fourier transform infrared spectroscopy (FT-IR), elemental analysis (EA), thermogravimetric analysis (TGA), X-ray diffractometry (XRD), and scanning electron microscopy (SEM) to investigate chitin structure isolated from both sexes of four grasshopper species. FT-IR, EA, XRD, and TGA showed that the chitin was in the alpha form. With respect to gender, two main differences were observed. First, we observed that the quantity of chitin was greater in males than in females and the dry weight of chitin between species ranged from 4.71% to 11.84%. Second, using SEM, we observed that the male chitin surface structure contained 25-90 nm wide nanofibers and 90-250 nm nanopores, while no pores or nanofibers were observed in the chitin surface structure of the majority of females (nanofibers were observed only in M. desertus females). In contrast, the elemental analysis, thermal properties, and crystalline index values for chitin were similar in males and females. Also, we carried out enzymatic digestion of the isolated chitins using commercial chitinase from Streptomyces griseus. We observed that there were no big differences in digestion rate of the chitins from both sexes and commercial chitin. The digestion rates were for grasshoppers' chitins; 88.45-95.48% and for commercial chitin; 94.95%.

The quick extraction of chitin from an epizoic crustacean species (Chelonibia patula).

Chitin was isolated from the shells of Chelonibia patula (barnacle, Crustacea), which lives on blue crab epizoically, following a 10-min demineralisation process through HCl and a 20-min deproteinisation process through NaOH. Due to the low-crystalline structure, and mineral-rich and low-protein content of the shells, chitin isolation was convenient. It was observed that the shell structure of C. patula contains 3.11% chitin per its dry weight. Following characterisation of the isolated chitin by using Fourier transform infrared spectroscopy, thermogravimetric analysis, X-ray diffractometry, elemental analysis and scanning electron microscopy, it was determined that there was close similarity with the α-chitin isolated from crabs, shrimps and insects in various studies. It was observed that chitin was composed of nanofibres with a width of 10-20 nm. It was concluded that this was an economically advantageous chitin resource compared with crustaceans such as shrimp, crayfish and crab, because it is possible to isolate chitin in a significantly shorter time.

Epicardial fat tissue thickness in preeclamptic and normal pregnancies.

Background. Epicardial fat tissue, another form of visceral adiposity, has been proposed as a new cardiometabolic risk factor, and the possible association of epicardial fat with hypertension has been shown in some recent studies. Although epicardial fat thickness (EFT) is associated with hypertension, the relationship between preeclampsia and EFT is still unknown. The purpose of this paper is to investigate the association between the echocardiographic EFT and the severity of preeclampsia in pregnant women. Methods. Forty women with preeclampsia were recruited and thirty-five normal pregnant women were matched for both maternal age and gestastional age served as control. The materials were collected immediately after delivery of the fetus, before placenta expulsion and before clamping of the umblical cord in patients and controls whom were in fasting state. Total cholesterol, high-density lipoprotein cholesterol (HDL), and triglyceride levels (TG) and low-density-lipoprotein cholesterol (LDL), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were assessed. EFT was measured by using transthoracic echocardiography. Results. Among the preeclamptic women, 12 were diagnosed with severe preeclampsia and 28 mild preeclampsia. There were no statistically significant differences between patients with preeclampsia and normal pregnancy except when they are divided according to systolic and diastolic blood pressure, proteinuria levels, and parity and EFT levels. Among women with preeclampsia (n = 40), 30% had severe disease. Women with mild and severe preeclampsia had significiantly higher blood pressures at delivery and earlier gestational ages in comparison to control subjects. Although TG, VLDL and LDL, HDL, and HOMA-IR levels (P > 0.05) were comparable between preeclampsia and normal pregnancies, EFT levels were significiantly higher in patients with preeclampsia. Moreover, in subgroup analysis, patients with severe preeclampsia had higher EFT levels (P < 0.05) in comparison with mild preeclampsia. Conclusions. EFT levels measured at delivery were increased in patients with preeclampsia, and patients with increased levels of EFT levels had a substantially higher probability of the disease severity in comparison to those with mild preeclampsia and controls.