Case report: Pai syndrome with multiple ventricular septal defect and without cleft palate.

Pai syndrome is described as the association of a midline cleft lip, midline facial polyps, and lipoma of the central nervous system. However, only a few patients present the full triad, and most exhibit a wide spectrum of phenotypic variability. Its entire clinical spectrum is still poorly delineated and the etiology remains unknown. In this report, a newborn was presented with congenital nasal septal lipoma, lipoma of the corpus callosum, multiple ventricular septal defect, and additional minor facial dysmorphism. This entity, multiple ventricular septal defect, which has never been reported in PS. Cytogenetic analysis showed normal male 46, XY karyotype. Chromosomal microarray analysis (750 K array) was also unremarkable. This case draws attention with the presence of multiple ventricular septal defect in Pai syndrome and is important in terms of providing phenotypic diversity. To our knowledge, this is also the first genetically evaluated case of Pai syndrome from Turkey.

Galectin-1 as a potential diagnostic biomarker in polycystic ovary syndrome.

OBJECTIVE: This study was aimed at comparing the routine laboratory parameters and Galectin-1 levels of control and polycystic ovarian syndrome patients. PATIENTS AND METHODS: 88 patients diagnosed with polycystic ovary syndrome and 88 healthy controls were considered for the study. Age groups of the patients ranged from 18 to 40. Serum TSH, Beta HCG, glucose, insulin, HOMA-IR, Hb1A1c, triglyceride, total cholesterol, LDL FSH, LH, E2, prolactin, testosterone, SHBG, DHESO4, HDL, Gal-1 levels were analyzed for each subject. RESULTS: FSH, LH, LH/FSH, E2, prolactin, testosterone, SHBG, DHESO4, HDL and Gal-1 values of the subjects included in the study were statistically significantly different between the groups (p<0.05). Gal-1 and DHESO4 showed a strong positive connection (p=0.05). The sensitivity of Gal-1 level in PCOS patients was calculated as 0.997 and specificity as 0.716. CONCLUSIONS: High levels of Gal-1 in PCOS patients suggest that it increases due to overexpression in response to inflammation.

Preservation of supraclavicular nerve while harvesting supraclavicular lymph node flap.

Lymph node transfer has recently become one of the popular techniques for surgical treatment of lymphedema. We aimed to evaluate postoperative donor site numbness and other complications in patients who underwent supraclavicular lymph node flap transfer to treat lymphedema with preservation of the supraclavicular nerve. From 2004 to 2020, 44 cases of supraclavicular lymph node flap were reviewed retrospectively. In the donor area, sensorial evaluation was clinically done with the postoperative controls. Among them 26 had no numbness at all, 13 had short-term numbness, two had numbness for > 1 year and three had numbness for > 2 years. We suggest that careful preservation of the supraclavicular nerve branches can avoid the major complication of numbness around the clavicle.

The effect of COVID-19 on patients recieving omalizumab treatment.

Background and aim: Although exposure during drug administration and susceptibility to coronavirus disease-19 (COVID-19) infection secondary to immunomodulatory effects constitute potential risks for patients with chronic spontaneous urticaria (CSU) or asthma on omalizumab (OMZ), there is a risk of loss of response following discontinuation of OMZ. There are few studies describing the clinical course of COVID-19 in patients receiving OMZ. Materials and methods: A total of 103 patients on OMZ were included in the study between February 2021 and January 2022. Results: Fourteen (13.6%) of the patients participating in the study had SARS-CoV-2 infection, of whom 3 (21.4%) required hospitalization and 11 (78.6%) were treated in an outpatient clinic. During the pandemic, 17 (16.5%) of the patients interrupted their OMZ treatment. Patients on OMZ for six months or less had a lower rate of interruption (2.5%) than those on OMZ for more than 6 months (25.4%). Patients interrupted treatment for the following reasons: 3 (17.6%) had COVID-19, 10 (58.9%) did not attend the hospital visit due to concern about contamination with SARS-CoV-2, and 4 (23.5%) thought that OMZ treatment would facilitate contamination with SARS-CoV-2. After interrupting OMZ, 3 (25%) female patients and 5 (100%) male patients presented no worsening of their symptoms. Three (13%) of the patients on OMZ for asthma and 11 (13.8%) of those on the drug for urticaria had COVID-19 infection. Patients presenting CSU and severe asthma are completely different, with different potential consequences of OMZ interruption. Nine (52.9%) patients had aggravated symptoms following interruption of OMZ treatment. Three of them described worsening of asthma symptoms and a need to increment their maintenance therapy due to asthma exacerbation after nearly three weeks of interruption, and 6 of them had hives and pruritus as urticaria exacerbation nearly four weeks after interruption of OMZ. The asthma patients did not stop their other treatments, including inhaled corticosteroids. Conclusion: Use of OMZ does not increase the risk of SARS-CoV-2 infection, COVID-19-related pneumonia, or COVID-19-related hospitalization. We advise patients not to interrupt OMZ treatment during the COVID-19 pandemic unless advised to do so by their doctors, and we recommend that they receive instruction concerning self-administration of OMZ to avoid visiting hospitals in the event of a pandemic.

Buts de l'étude: Bien que l'exposition lors de l'administration du médicament et la susceptibilité individuelle à l'infection par le coronavirus-19 (COVID-19) secondaire aux effets immunomodulateurs soient des risques potentiels pour le patient victime d'urticaire chronique idiopathique (UCI) ou d'asthme recevant de l'omalizumab (OMZ), il existe également un risque de perte de réponse au traitement à la suite de l'arrêt de l'OMZ. Matériels et méthodes: Un total de 103 patients recevant de l'OMZ ont été inclus dans l'étude entre février 2021 et janvier 2022. Résultats: Quatorze (13,6 %) patients participant à l'étude ont été victimes d'une infection à coronavirus, 3 d'entre eux (21,4 %) ont été hospitalisés et 11 (78,6 %) ont été traités en ambulatoire. Durant la pandémie, 17 (16,5 %) patients arrêtèrent le traitement par OMZ. Le taux d'arrêt était plus faible (2,5 %) chez les patients recevant l'OMZ depuis 6 mois ou moins par rapport aux patients recevant l'OMZ depuis plus de 6 mois (25,4 %). L'arrêt du traitement était motivé par l'infection COVID-19 dans 3 cas (17,6 %), par une non-fréquentation de l'hôpital par crainte de contagion dans 10 cas (58,9 %), et dans 4 cas (23,5 %) parce qu'ils pensaient que l'OMZ favorisait l'infection COVID-19. Après l'arrêt de l'OMZ, 3 (25 %) femmes et 5 (100 %) hommes n'ont présenté aucune aggravation de leurs symptômes. Trois (13 %) patients recevant de l'OMZ pour asthme et 11 (13,8 %) pour de l'UCI présentèrent une infection par COVID-19. Les patients souffrant d'UCI ou d'asthme sévère étaient totalement différents, avec des conséquences potentielles différentes de l'interruption de l'OMZ. Neuf (52,9 %) patients aggravèrent leurs symptômes à l'arrêt de l'OMZ. Trois d'entre eux décrivirent une accentuation des symptômes d'asthme avec besoin d'augmenter leur traitement de fond pour exacerbation d'asthme après près de 3 semaines d'arrêt, et 6 d'entre eux présentèrent une exacerbation de l'urticaire avec papules et prurit après près de 4 semaines d'arrêt de l'OMZ. Les asthmatiques n'arrêtèrent pas les autres médicaments dont les corticostéroïdes inhalés. Conclusion: L'OMZ n'augmente pas les risques d'infection par COVID-19, ni les pneumopathies liées à l'infection COVID-19, ni les hospitalisations dues au COVID-19. Nous prévenons les patients de ne pas interrompre leur traitement par OMZ pendant la pandémie par COVID-19 sans avis médical, et nous recommandons une éducation thérapeutique pour l'auto-administration d'OMZ pour éviter les séjours hospitaliers en cas de pandémie.

Determination of mTOR signal pathway in MMTV-TGFα mice ovary at different ages.

Transforming growth factor alpha (TGFα), a member of the epidermal growth factor (EGF) family, regulates cell proliferation, differentiation, and development, and involves follicular development and viability. In ovaries, TGFα is shown localized in granulosa cells (GCs) of primary follicles, theca cells (TCs) of pre-antral, antral and pre-ovulatory follicles. TGFα overexpression in mouse mammary tumor virus (MMTV-TGFα) transgenic mice causes mammary tumor after 50 weeks. However, follicular development and preservation of the ovarian follicle reserve-mediating follicle stimulating hormone (FSH) response are unknown. Mammalian target of rapamycin (mTOR) is a key regulator for cell proliferation, growth, differentiation, and apoptosis, and important for ovarian folliculogenesis and oocyte maturation. The study aim determines TGFα overexpression during folliculogenesis via mTOR signaling pathway in ovaries from 10-, 18-, 50-, and 82-week-old MMTV-TGFα mice. Histological analysis was performed, along with western blot for mTOR, p-mTOR, P70S6K, PCNA, and Caspase-3, and quantitative RNA (qRT-PCR) for mTOR and P70S6K. Developing follicles number decreased and atretic follicles number increased with aging in MMTV-TGFα mice ovary. Ovaries at 18 and 82 weeks had decreased PCNA and increased Caspase-3 protein expression levels as compared to 10-week ovaries. Protein expression levels of mTOR and p-mTOR decreased gradually from ovaries at 10-18 weeks, increased at 50 weeks and decreased again at 82 weeks. These results indicate that TGFα may be one regulator of healthy follicular development and affect mTOR signaling pathway during ovarian aging. Thus, over-expression of TGFα might lead to reduced ovarian reserve and premature ovarian insufficiency.

The percentage of hesitation and factors associated with acceptance or refusal for COVID-19 vaccine: Does training about vaccines by allergist affect personal decision?

Background and aim: As the impact of coronavirus disease (COVID)-19 arises worldwide, the effect of vaccines is protecting its importance. The aim of this study was to investigate the vaccination perspectives of patients and learn how many patients were persuaded to get vaccinated with the effect of the education provided by allergists. Materials and methods: A cross-sectional study was carried out among 200 adult patients in the outpatient clinic between February 2021 and January 2022. Patients filled out the anti-vaccination scale form and a questionnaire form developed by allergists. The training about COVID-19 vaccines has been given to the patients who did not consider getting vaccinated. The patients were called by phone and questioned whether they have been vaccinated or not, after 22 weeks. Results: Out of 200 patients participants, 60.5% were considering getting vaccinated. Patients who did not consider getting vaccinated comprised 45.7% of women and 31% of men. While 52.4% of primary school graduates considered getting vaccinated, 75% of high school graduates and 60.8% of higher education graduates were considering getting vaccinated. Major reasons for rejecting vaccination were concerns about side effects and allergy. While the majority of women (47.2%) who did not want to get vaccinated were concerned about vaccine side effects, the majority of men (34.6%) did not want to get vaccinated because they did not trust the efficacy of the vaccine. Vaccination rates have been increased with the training we provided to our patients who did not consider getting the vaccine. 76 patients could be reached by phone and 81.6% of them were vaccinated, and 18.4% were not. Conclusion: The vaccination rates of allergy patients who did not consider getting vaccinated were increased with the information provided by allergists. So, the allergists should give more attention for giving information and increasing the vaccination rates of covid-19.

But de l: 'étude Alors que l'épidémie de maladie à coronavirus (COVID-19) impacte le monde entier, l'effet préventif de la vaccination est de première importance. Le but de cette étude était d'évaluer les souhaits de vaccination des patients et d'apprécier combien d'entre eux étaient persuadés de l'intérêt de celle ci après avoir bénéficié d'un parcours éducatif auprès des allergologues. Matériel et Méthodes: Une étude transversale a été menée parmi 200 patients adultes suivis en ambulatoire entre février 2021 et janvier 2022. Les patients renseignaient une échelle analogique de refus de vaccination et un questionnaire élaboré par des allergologues. Une éducation thérapeutique sur les vaccins pour la COVID-19 était dispensée aux patients refusant la vaccination. Les patients étaient ensuite contactés par téléphone pour savoir s'ils avaient été ou non vaccinés après 22 semaines. Résultats: Parmi les 200 patients, 60,5 % étaient considérés comme vaccinés. Les patients non vaccinés concernaient 45 % des femmes et 31 % des hommes. Alors que 52,4 % des patients ayant suivi une scolarité primaire étaient vaccinés, 75 % des patients de, niveau lycée et 60,8 % de niveau université se déclaraient vaccinés. Les raisons principales de refus de vaccination concernaient la crainte d'effets secondaires et le risque allergique. Alors que la majorité des femmes (47,2 %) refusant la vaccination alléguait le risque d'effets secondaires, la majorité des hommes (34,6 %) ne souhaitait pas être vaccinée pour non confiance dans l'efficacité du vaccin. Les désirs de vaccination étaient augmentés après éducation thérapeutique chez les patients ne souhaitant pas être vaccinés. Ainsi 76 patients ont pu être joints par téléphone et 81,6 % d'entre eux avaient pu être vaccinés et 18,4 % ne l'étaient pas. Conclusion: Les taux de vaccination des patients allergiques qui ne souhaitaient pas être vaccinés ont été augmentés après l'information fournie par les allergologues. Ainsi les allergologues devraient apporter toute leur attention à donner des informations visant à augmenter la vaccination pour la COVID-19.

Neutrophil-to-albumin ratio: a promising tool for CAD assessment in non-ST elevation AMI.

OBJECTIVE: In the context of coronary artery disease (CAD) pathogenesis, inflammation has emerged as a critical player. This study investigates the potential of the Neutrophil-to-Albumin Ratio (NAR) as a novel biomarker for assessing CAD severity and extension in patients suffering from acute myocardial infarction (AMI) without ST-segment elevation. PATIENTS AND METHODS: We conducted a comprehensive analysis of consecutive patient records (n = 211) from a single center, focusing on individuals diagnosed with non-ST elevation AMI. To gauge CAD severity, we employed Syntax Scores (SS) and examined their correlation with NAR, C-reactive protein-albumin ratio (CRPALB), and the systemic immune inflammation index (SII). Statistical analyses were conducted to establish associations and predictive capabilities. RESULTS: Our analysis revealed a significant correlation between NAR and Syntax Scores (r: .416, p<0.01). Notably, patients with intermediate-high SS exhibited significantly elevated NAR values compared to those in the low SS group [20.86+5.38 vs. 16.41+6.30 (p<0.001)]. Furthermore, NAR outperformed CRPALB, SII, and Neutrophil Percent-to-Albumin Ratio (NPAR) in discriminating CAD severity, as demonstrated by the Receiver Operating Characteristic (ROC) curve analysis (NAR AUC: 0.736; CRPALB AUC: 0.673; SII AUC: 0.660; NPAR AUC: 0.717). CONCLUSIONS: This study underscores the potential of NAR as a robust predictor of CAD severity and extension in non-ST elevation AMI patients. While previous markers, such as CRPALB and SII, are advantageous, NAR's superior predictive capabilities are a valuable addition to the clinician's toolkit, offering enhanced risk assessment for this specific patient subgroup.

NIVOLUMAB ASSOCIATED ENDOCRINE ABNORMALITIES: CHALLENGING CASES FROM A REFERENCE CLINIC.

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced cancers. Antibodies directed against programmed cell death receptor 1 (PD-1) interrupt the ability of the cancerous cell to depress the immune system. Methods and results: We report three patients who developed different endocrine abnormalities after treatment with nivolumab, a monoclonal antibody directed against PD-1. First, we report a 76-year-old male presenting with generalized fat loss after treatment with nivolumab which predominantly affected his face and trunk. Second, we described the development of thyroiditis that presented with thyrotoxicosis and the expression of thyroid-stimulating hormone receptor antibodies (TRAb). Finally, we observed the emergence of adrenal insufficiency due to hypophysitis in another case. Conclusion: Although immune checkpoint inhibitors are an effective anticancer treatment modality, adverse effects are evident that can affect the endocrine system. These adverse events may relate to different endocrine systems that include the thyroid and pituitary glands. Also, acquired generalized lipodystrophy should be suspected in patients developing unusual fat loss after treatment with ICIs.

Radiation dose during fluoroscopically guided central venous access device insertion: retrospective observational study. / Dosis de radiación durante la inserción guiada por fluoroscopia de un dispositivo de acceso venoso central: un estudio observacional retrospectivo.

INTRODUCTION: Central venous access devices (CVAD) are used to deliver intravenous therapy to the bloodstream. CVAD insertion is sometimes fluoroscopically guided and thus associated with radiation dose to both the patient and the staff members within the room. The objective of this study is to assess the radiation dose to the patient through a retrospective audit and directly measure the exposure to staff members in simulated procedures. A secondary objective is to evaluate the radiation exposure to the staff and patients when utilising fluoroscopic pulse rate of 7.5 pps and 4 pps. MATERIAL AND METHODS: A retrospective audit of patients undergoing Permcath and Hickman line insertions was conducted. The patients were grouped by the pulse rate used for the duration of the study; 4 pulses per second (pps) (n=24) and 7.5 pps (n=33). A STEP OD-2 monitor and PMMA was used in a simulated environment to estimate the radiation exposure to locations that a Radiologist, Nurse and Radiographer would be standing during the procedures using the average procedure details collected in the retrospective audit. Measurements were conducted at heights to reflect a whole body estimate and an estimate to the lens of the eye. RESULTS: The results show that the median dose area product (DAP) for CVAD insertion is 0.7Gy.cm2 and 0.3Gy.cm2 for procedures done at 7.5 pps and 4 pps, respectively. This corresponded to an effective dose of 0.22 mSv and 0.1 mSv. The radiologist, nurse and radiographer were exposed to a whole-body shielded dose of 0.36µSv, 0.1µSv and 0.05µSv when 7.5 pps was utilised and 0.13µSv, 0.03µSv and 0.02µSv when 4 pps was used. The exposure to the head of radiologist, nurse and radiographer was 2.1µSv, 1.4µSv, and 0.6µSv in the 7.5 pps studies and 0.7µSv, 0.5µSv, and 0.2µSv when 4pps was used. CONCLUSION: The patient effective dose was estimated to be 0.1-0.22 mSv depending on the fluoroscopic pulse rate utilised during CVAD insertions. Additionally, The radiologist, nurse and radiographer whole body and lens exposure was estimated in a simulated setting. In all cases, there was a statistically significant dose reduction when the lower fluoroscopic pulse rate was used. Thus, where possible, consideration should be given to utilising a lower pulse rate during CVAD insertions to reduce the exposure to both staff and patients.

The negative effect of desflurane on reproductive capacity in female rats.

AIM: The aim of this study was to determine the effect of desflurane on reproductive capacity in female rats through a study of biochemical evaluations. METHOD: After experimental procedure, the blood samples of female rats were collected, and the malondialdehyde, interleukin­1­beta, total glutathione and superoxide dismutase levels were measured to evaluate oxidative stress. In addition to biochemical evaluations, the reproductive performance of the experimental groups was also examined. RESULTS: The results of our study demonstrated that in blood samples of desflurane­treated groups of rats, the parameters indicating oxidative stress and inflammation increased, and antioxidant parameters decreased (p < 0.05). It was also proven that repeated desflurane doses caused infertility in female rats, prolonged the gestation period and reduced the number of offspring. CONCLUSIONS: This study showed that recurrent desflurane application can cause infertility problems through oxidative stress in female rats (Tab. 3, Fig. 1, Ref. 25).

The effects and mechanisms of the action of galangin on spatial memory in rats.

BACKGROUND: Galangin, a flavonoid compound with acetylcholinesterase inhibitory activity, may improve cognitive functions by enhancing cholinergic transmission. OBJECTIVES: We aimed to investigate the effects of galangin on spatial memory impairment in rats. METHODS: The effects of galangin (50 and 100 mg/kg) and reference anti-dementia drug donepezil (1mg/kg) administrations were examined on memory impairment induced by the muscarinic cholinergic receptor antagonist scopolamine or the nicotinic cholinergic receptor antagonist mecamylamine in the Morris water maze (MWM) test. Hippocampal acetylcholine concentrations were also determined. RESULTS: Galangin 50 and 100 mg/kg significantly decreased the mean distance to platform and increased the time spent in the escape platform quadrant in scopolamine-treated rats. Galangin 100 mg/kg significantly decreased the mean distance to platform and increased the time spent in the escape platform quadrant in mecamylamine-treated rats. The effects of galangin in the MWM were comparable with donepezil. Scopolamine and mecamylamine decreased acetylcholine concentrations, whereas galangin both alone and with mecamylamine or scopolamine administration increased acetylcholine concentrations. CONCLUSION: Galangin improved memory impairment comparable to donepezil and nicotinic and muscarinic receptors may be involved in this effect. Galangin may be considered as a promising flavonoid in the prevention and treatment of memory impairment in Alzheimer's disease and other dementias (Fig. 7,Ref. 37).

The effects of exhaustive swimming and probiotic administration in trained rats: Oxidative balance of selected organs, colon morphology, and contractility.

The duration and intensity of exercise are significant factors in oxidative, morphological, and functional changes of the gastrointestinal tract. This study aimed to investigate the effects of both exhaustive swimming and probiotic VSL#3 on rats that had been previously trained with moderate swimming. The rats were divided into four groups labeled: control (C), probiotic (P), exercise (E), and probiotic-exercise (PE). Groups P and PE were fed with probiotic mixture VSL#3. Groups E and PE had a 5-week moderate swimming program (1 h/day for 5 days/week), followed by a 1-week exhaustive swimming program (trained like in moderate program but 3 times with 150 min resting sessions, for 5 days/week). At the end of the program, the rats were euthanized. Malondialdehyde, superoxide dismutase, catalase, and reduced glutathione levels were measured in tissue samples from the gastrocnemius muscle, heart, liver, kidney, and colon. In vitro contractile activity and histomorphology of the colon were also determined. Exercise and/or probiotic decreased the oxidative stress and also increased the level of one or more of the antioxidant enzymes in some of the organs. Probiotics had more pronounced effects on colon morphology than exercise but unexpectedly this effect was non-trophic. In the colon, the thickness of the tunica muscularis and the number of goblet cells were not affected; however, probiotic administration decreased the crypt depth and tunica mucosa thickness. Exercise increased the Emax value of acetylcholine (ACh), while decreased its sensitivity. These findings suggest that exhaustive swimming does not cause oxidative stress and that probiotic consumption improves oxidative balance in trained rats. The probiotic intake does not alter the effect of exercise on the contractile activity of the colon. Colon mucosal changes induced by probiotics are independent of exercise.

Path Analysis of Campus Walkability/Bikeability and College Students' Physical Activity Attitudes, Behaviors, and Body Mass Index.

PURPOSE: The purpose of this study was to assess the relationship between the walkability/bikeability of college campuses and students' body mass index (BMI) with student physical activity (PA) attitudes and behaviors as potential mediators. DESIGN: Cross-sectional. SETTING: Thirteen university campuses. PARTICIPANTS: A total of 1384 student participants. MEASURES: Walkability/bikeability environmental score (ES): 12-item audit assessed an average of 44 path segments per campus. Students were measured for height and weight and completed online surveys. Physical activity stage of change/behavior intentions were assessed using the transtheoretical model. The Cognitive Behavioral Physical Activity Questionnaire assessed outcome expectations, self-regulation, and personal barriers. International Physical Activity Questionnaire assessed walking-, moderate-, and vigorous-intensity PA. ANALYSIS: Descriptive statistics, zero-order correlations, and path analysis with maximum likelihood estimation. RESULTS: The overall model fit was good with χ2 of 171.388 ( df = 18), P < .001, comparative fit index value of .95, and a root mean square of approximation of .079. After controlling for gender, there was a direct negative association between walkability/bikeability ES and BMI (ß = -.085) and positive association between personal barriers and BMI (ß = .134). Walkability/bikeability ES was positively associated with walking-intensity PA (ß = .010). Self-regulation was positively associated with moderate-intensity PA (ß = .213), which, in turn, was negatively associated with BMI (ß = -.057). CONCLUSIONS: The ease of walking and biking on a campus was related to college students' walking behavior and their BMI. Students' PA behavioral intentions were associated with moderate PA and lower BMI. These results provide evidence to focus on policies and structural supports for walkable/bikeable environments to supplement and enhance interventions encouraging individual behavior change for PA and weight management.

Effect of alginate in patients with GERD hiatal hernia matters.

Alginate-based formulations are frequently used as add-on proton pump inhibitor (PPI) therapy to help control of heartburn and regurgitation. There are limited data regarding the mechanisms and effects of alginate-based formulations. We aimed to evaluate the effects of the sodium alginate intake and its likely temporal relations on intraesophageal reflux events by MII-pH in patients with and without hiatal hernia (HH). Fifty GERD patients (18 with HH, 32 without HH) with heartburn or regurgitation once a week or more common were included. After combined multichannel intraluminal impedance and pH-metry (MII-pH) had been performed, all patients were asked to eat the same standard meal (double cheeseburger, 1 banana, 100 g regular yoghurt, and 200 mL water with total energy value of 744 kcal: 37.6% of carbohydrates, 21.2% of proteins, and 41.2% of lipids) during two consecutive days. On separate random two consecutive days, all patients took 10 mL of sodium alginate (GA; Gaviscon Advance; Reckitt Benckiser Healthcare, Hull, UK) or 10 mL of water, 30 minutes after the refluxogenic meal. After eating refluxogenic meal, patients were examined ½ hour for basal conditions, 1 hour in upright, and 1 hour in supine positions. Alginate significantly decreased acid reflux after intake at the first hour in comparison to water in patients with HH (6.1 vs. 13.7, P = 0.004) and without HH (3.5 vs. 5.5, P = 0.001). Weakly acid reflux were increased at the first hour in patients with HH (3.4 vs. 1.3, P = 0.019) and without HH (1.7 vs. 5, P = 0.02) compared to water. There was no distinctive effect of alginate on the height of proximal migration of reflux events in patients with HH and without HH. Alginate decreases acid reflux events within a limited time period, especially at the first hour both in patients with and without HH. Alginate has no effect on the height of reflux events along the esophagus both in patients with and without HH.

Can N-terminal pro B-type natriuretic peptide, neutrophil-to-lymphocyte ratio, C-reactive protein help to predict short and long term mortality?

BACKGROUND: There is limited data about ICU, short and long-term mortality prediction of severe CAP with neutrophil-to-lymphocyte ratio (NLR): N-terminal proB- type natriuretic peptide (NT-proBNP): C-reactive protein (CRP). AIM: Besides the known severity indexes of ICU, can NLR, NT-proBNP, CRP predict ICU, short and long term mortality? METHODS: A retrospective cohort study was carried out in a level III ICU of a tertiary training hospital for chest diseases and thoracic surgery. RESULTS: Over the study period, a total of 143 patients were enrolled in the study. The APACHE II scoring showed a significantly higher predicting performance for ICU mortality (p = 0.002). The performance for predicting short term mortality NLR (p = 0.039) and long term mortality NTproBNP (p = 0.002) had a significantly higher performance. The survival analysis revealed that mortality was significantly higher in patients with CURB65 score ≥ 4 (p = 0.047). CONCLUSION: NLR, NTproBNP > 2000pg/mL can be used to predict pneumonia severity in ICU alike CURB65 and PSI. Higher NLR, APACHE II and atrial fibrillation can cause an important mortality factor in long term. Consequently, clinicians should take an attention for good cardiac evaluation and cardiac follow-up of patients with CAP (Tab. 4, Fig. 3, Ref. 36).

Assessment of periapical health, quality of root canal filling, and coronal restoration by using cone-beam computed tomography.

AIM: The purpose of this study is to use cone-beam computed tomography (CBCT) to describe the prevalence of apical health, the quality of root canal filling, and coronal restorations of endodontically treated teeth in the east Anatolian subpopulation of Turkey. MATERIALS AND METHODS: CBCT scans were taken from 748 patients attending for the 1st time to the clinic at the Oral Diagnosis and Radiology Department at Ataturk University's Faculty of Dentistry in Erzurum, Turkey. All images were analyzed by two research assistants who were trained using examples of CBCT images with and without the presence of periapical radiolucency. The two examiners assessed images from the experiment independently, and the readings were then compared. All data were entered on an MS Excel 2007 spreadsheet and SPSS software 15.0 which was used for statistical analysis. The Chi-square test was used to determine if a patient's periapical status was associated with the technical quality of root filling, coronal status, and to evaluate differences between tooth subgroups. RESULTS: In total, 147 teeth from 748 patients were found to have been treated endodontically. Sixty three teeth were found to have short root canal fillings, whereas 74 teeth had adequate root canal fillings, and the remaining 10 teeth had over extended root canal filling. A significant correlation was observed between the length of root filling and apical periodontitis (P = 0,023). Inadequately dense root canal filling was observed in 141 teeth, whereas adequately dense filling was found in only six teeth. There was a significant correlation between the density of root filling and apical periodontitis (P = 0.044). Coronal restoration was found in 90 teeth, but was not observed in all the three teeth. A crown was present in 54 teeth. There was a significant correlation between coronal restoration and apical periodontitis (P = 0.028). CONCLUSION: The results indicate that the quality of both the root filling and restoration were found to have impact on the periapical health of root-filled teeth.

Metagenomic bacterial community profiles of chicken embryo gastrointestinal tract by using T-RFLP analysis.

Thirty microbial phylotypes of microorganisms were found in the gastrointestinal tract of chicken belonging to the Hajseks White breed, and 38 phylotypes were found in the gastrointestinal tract of chicken belonging to the Hajseks Brown breed. The microbiome of the gastrointestinal tract of the chicken embryos of the Hajseks White breed was dominated by the typical representatives of avian intestinal microflora--bacteria of the family Enterobacteriaceae (47.3%), orders Actinomycetales (13.6%) and Bifidobacteriales (20.6%), and the family Lachnospiraceae (1.1%). The microbiome of the gastrointestinal tract of the chicken embryos of the Hajseks Brown breed was dominated by the pathogenic bacteria of the order Rickettsiales (94.8%). The metagenome of gastrointestinal tract of both breeds also contained a small number of genes of unidentified bacteria.

Reliability of the i-STAT for the determination of blood electrolyte (K+, Na+, and CI-) concentrations in cattle.

BACKGROUND: Rapid determination of blood electrolyte concentrations can help determine electrolyte status and delivery of effective volume of electrolyte solutions in field conditions. OBJECTIVE: To evaluate reliability of the i-STAT, a point-of-care (POC) device, in measuring blood K(+), Na(+), and CI(-) concentrations in cattle. ANIMALS: Ninety-eight cattle with various diseases. METHODS: In this prospective study, blood samples collected from the jugular vein were processed for determination of K(+), Na(+), and CI(-) concentrations in blood and plasma using the i-STAT and auto-analyzer (Cobas C501), respectively. Blood and plasma electrolyte data were subjected to student t-test for comparison, the concordance analysis for agreement, accuracy, and precision, the Passing-Bablok regression and the Bland-Altman plot for reliability, and receiver operating characteristics curves for sensitivity (Se) and specificity (Sp). RESULTS: Plasma concentrations of K(+) (4.39 versus 4.2 mmol/L; P < .0001) and CI(-) (100.30 versus 99.4 mmol/L; P < .04) were greater than their concentrations in blood. Plasma and blood Na(+) concentrations were similar (136.95 versus 136.8 mmol/L). The i-STAT results were highly correlated with the Cobas C501 results (r = 0.970, 0.922, and 0.866 for K(+), Na(+), and CI(-), respectively). Regression equations fitting blood (Y) and plasma (X) concentration did not deviate from the identity line for K(+) (Y = -0.10 + 0.98 × X), Na(+) (Y = X), and CI(-) (Y = 3.04 + 0.96 × X). The mean bias (blood concentration - plasma concentration) was -0.20 for K(+) (P = .03), -0.16 for Na(+) (P = .12), and -0.87 for CI(-) (P = .93). The i-STAT had 76-100% Se and 87.7-100% Sp for assessing electrolyte statuses. CONCLUSIONS AND CLINICAL IMPORTANCE: The i-STAT yielded results that were in agreement with the auto-analyzer, with negligible biases in measurement of plasma K(+), Na(+), and CI(-) concentrations. The i-STAT is a reliable POC device and can be used in field condition to assess electrolyte status in cattle.

The effects of magnesium sulphate on the contractile activity of uterus in an animal model of preeclampsia.

PURPOSE: This study was undertaken to evaluate the effects of magnesium sulfate (MgSO4) on the contractile activity of the uterus in a pregnant rat model of preeclampsia induced by N-nitro-arginine methyl ester (L-NAME). MATERIALS AND METHODS: Twenty-eight, 160-220 gram, three to four month old female Sprague-Dawley rats were used in this study. After conception was confirmed by vaginal smears on the first day of pregnancy, the animals were allocated into four groups according to the chemicals fed in their drinking water as control (nothing administered), L-NAME (50 mg/kg L-NAME), MgSO4 (600 mg/kg MgSO4), and MgSO4 + L-NAME group (600 mg/kg MgSO4 + 50 mg/kg L-NAME). The pregnant uterus strips were isolated on the 19th day and the contractile activity of uterus was examined by applying 0, 0.1, 0.2, 0.4, 0.8, and 2.5 mIU/ml oxytocin to each group and responses are recorded accordingly. RESULTS: There were no statistically significant differences regarding fetal parameters and peak amplitudes of the oxytocin stimulated pregnant rat myometrial strips among groups. In L-NAME group at 0 and 0.1 mIU/ml oxytocin, the contraction frequency in a ten-min period was statistically lower than the control group (Z = -2.850, p = 0.004; Z = -2.902, p = 0.004, respectively). In MgSO4 group only at 0 mIU/ml oxytocin, the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = -2.973,p = 0.003). In L-NAME + MgSO4 group at 0, 0.1 and 0.2 mIU/ml oxytocin concentrations the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = - 4.018, p = 0.000; Z = -3.237, p = 0.001; Z = -2.902, p = 0.004, respectively). In L-NAME + MgSO4 given group at each oxytocin concentrations, the frequencies of the contractions in ten-min period were lower but not statistically different than the L-NAME group. CONCLUSION: MgSO4 has no significant effect on the amplitude of spontaneous or oxytocin induced myometrial contractions, but decreased the frequency of spontaneous contractions. At each doses of oxytocin, MgSO4 has no significant effect on the frequency of contraction in a pregnant rat model of preeclampsia induced by L-NAME.

Synthesis and monoamine oxidase inhibitory activities of some 3-(4-fluorophenyl)-5-aryl-n-substituted-4,5-dihydro-(1H)-pyrazole-1-carbothioamide derivatives.

28 new 3-(4-fluorophenyl)-5-aryl-N-substituted-4,5-dihydro-1H-pyrazole-1-carbothioamide derivatives were synthesized and evaluated in vitro for their monoamine oxidase (MAO) A and B inhibitory activity and selectivity. The derivatives substituted by halogen on the fifth position of pyrazole ring, inhibited MAO-A enzyme with a high selectivity index. On the other hand, compounds substituted with 2-naphthyl inhibited MAO-B enzyme with a moderate selectivity index. Docking studies were done to highlight the interactions of the most active derivative with the active site of MAO-A. In addition, in vivo antidepressant and anxiolytic activities of the compounds having selective MAO-A inhibitory effects, were investigated by using Porsolt forced swimming and elevated plus-maze tests respectively. 3-(4-Fluorophenyl)-5-(4-chloro-phenyl)-N-allyl-4,5-dihydro-1H-pyrazole-1-carbothio-amide has antidepressant, 3-(4-fluorophenyl)-5-(4-chlorophenyl)-N-methyl-4,5-dihydro-1H-pyrazole-1-carbothioamide and 3-(4-fluoro-phenyl)-5-(4-bromophenyl)-N-ethyl-4,5-dihydro-1H-pyrazole-1-carbothioamide have anxiolytic activity.