Enhancement of yogurt functionality by adding Mentha piprita phenolic extract and evaluation of its quality during cold storage.

New functional food products with health benefits are currently in high demand among health-conscious consumers. The present research aims to improve the functional properties of yogurt by adding peppermint hydroethanolic extract (PHE) at different doses. The impact of PHE (0%, 2%, 4%, and 6%) on yogurt was studied for acidity, pH, organoleptic quality, antioxidant activity, lipid peroxidation, and fatty acid profile. The results revealed that PHE is rich in phenolic compounds, of which rosmarinic acid was the main one (339.88 mg/g lyophilized extract) and has considerable antioxidant potential, which remarkably (p < .01) increased antioxidant capacity in yogurt by over 39.51%, even at a low dose of 2%, giving the product better protection against lipid peroxidation and preserving its physicochemical and sensory quality. At 4%, PHE increased significantly (p < .01) the content of omega-3 fatty acids, notably alpha-linolenic acid, in fortified yogurt compared with the control, and reduced (p < .01) the ratio of omega-6/omega-3, which dropped from 5.21 to 4.11. It looks feasible to prepare a yogurt with health-giving properties by adding Mentha piperita hydroethanolic extract at a concentration of up to 4% as an alternative to synthetic antioxidants, which would also extend its shelf life.

Comparison of fungemia caused by Candida and non-Candida rare yeasts: a retrospective study from a tertiary care hospital.

Although Candida species are the most common cause of fungemia, non-Candida rare yeasts (NCY) have been increasingly reported worldwide. Although the importance of these yeast infections is recognized, current epidemiological information about these pathogens is limited and they have variable antifungal susceptibility profiles. In this study, we aimed to evaluate the clinical characteristics for fungemia caused by NCY by comparing with candidemia. The episodes of NCY fungemia between January 2011 and August 2023 were retrospectively evaluated in terms of clinical characteristics, predisposing factor and outcome. In addition, a candidemia group including the patients in the same period was conducted for comparison. Antifungal susceptibility tests were performed according to reference method. A total of 85 patients with fungemia episodes were included; 25 with NCY fungemia, 60 with candidemia. Fluconazole had high minimal inhibitory concentration (MIC) values against almost all NCY isolates. The MIC values for voriconazole, posaconazole and amphotericin B were ≤ 2 µg/ml and for caspofungin and anidulafungin were ≥ 1 µg/ml against most of isolates. Hematological malignancies, immunosuppressive therapy, neutropenia and prolonged neutropenia, polymicrobial bacteremia/fungemia, preexposure to antifungal drugs and breakthrough fungemia were associated with NCY fungemia, whereas intensive care unit admission, diabetes mellitus, urinary catheters and total parenteral nutrition were associated with candidemia. In conclusion, the majority of fungemia due to NCY species were the problem particularly in hematology units and patients with hematological malignancy. Preexposure to antifungal drugs likely causes a change in the epidemiology of fungemia in favor of non-albicans Candida and/or NCY.

Use of Ozone Therapy and Thymoquinone in the Prevention of Formaldehyde Toxicity by Inhalation: An Experimental Study.

INTRODUCTION: The study determined the damage caused by formaldehyde (FA) exposure in blood and liver samples using biochemical markers. Histopathological analysis was performed using the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method and measurement of CD68 cell density. To what extent the antioxidant molecules thymoquinone (TQ) and ozone (O3) reversed the damage caused by FA exposure was investigated, both when used alone and combined. METHODS: Fifty-six Sprague-Dawley male rats of eight to ten weeks of age were used in the experiment. The rats were divided into eight groups, with seven rats in each group: the untreated control group, the group treated with TQ (10 mg/kg/day), the group treated with O3 (150 µg/kg/day), the group treated with TQ+O3, the group exposed to FA (10 ppm 8 h/day), the group receiving FA+TQ, the group receiving FA+O3, and the group receiving FA+TQ+O3. Serum aspartate transaminase (AST), alanine transaminase (ALT), total antioxidant (TAS, U/mL), and total oxidant (TOS, nmol/mL) levels were analyzed. TAS and TOS levels, CD68 cell density, and apoptotic cells were determined in liver tissues. RESULTS: FA exposure caused an increase in serum AST and ALT levels of (p<0.05) experimental animals, a decrease in TAS levels in serum (p=0.03) and liver (p>0.05) and an increase in TOS levels (p>0.05), TUNEL positivity (p<0.001), and CD68 cell density (p=0.004). Administration of TQ and O3 as antioxidants significantly reversed biochemical and histopathological alterations in the serum and liver. CONCLUSION: TQ and ozone therapy suppressed oxidative stress caused by FA exposure and reversed the emerging histopathological deteriorations. Ozone therapy did not suppress the effects of TQ. Therefore, ozone therapy can be given as a supportive therapy along with the main therapeutic agents. We think TQ and ozone therapy may be useful to protect individuals exposed to FA.

Potential Hepatoprotective Effect of Matricaria Pubescens on High-Fat Diet-Induced Non-Alcoholic Fatty Liver Disease in Rats.

This study aimed to identify the phytochemical compounds of Matricaria pubescens by LC-MS/MS and evaluate the potential protective effect of its supplementation in high-fat diet (HFD)-induced non-alcoholic fatty liver disease (NAFLD) in adult rats through modulation of oxidative stress and histopathological changes. Twenty-four male rats were randomly divided into four groups. The first group served as control and received the standard diet. The second group (HFD) received a high-fat diet only (30 % of sheep fat). The third group's (control+MP) animals received a standard diet supplemented with 5 % M. pubescens (w/w). The fourth group (HFD+MP) received a high-fat diet supplemented with 5 % M. pubescens for 16 weeks. LC-MS/MS analysis showed that M. pubescens contains many phytochemical compounds. It was observed that the ethanolic extract of M. pubescens has a higher phenolic content than the aqueous extract. The supplementation of M. pubescens (5 % w/w) to HFD rats decreased significantly (p<0.01) body weight, liver and epididymal adipose tissue relative weights, glycemia, triglycerides (TG), insulin resistance, liver markers, TNF-α, malondialdehyde (MDA), protein carbonyl (PCO), advanced oxidation protein products (AOPP) level, and increased reduced glutathione (GSH) level, glutathione peroxidase (GPx), glutathione-S-transferase (GST), superoxide dismutase (SOD), and catalase activities as well as ameliorated histological alterations through the reduction hepatic lipid deposition and adipocytes hypertrophy compared to the HFD group. We conclude that M. pubescens powder may be effective for correcting hyperglycemia, hypertriglyceridemia, insulin resistance, and liver markers while decreasing inflammation and oxidative stress in the liver of high-fat diet-fed rats.

The utility of the systemic immune inflammation and systemic inflammation response indices in suspected intermediate-risk pulmonary embolism.

AIM: To evaluate the utility of the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) in diagnosing pulmonary embolism (PE) in emergency medicine. METHODS: We retrospectively reviewed the data of patients who presented to the emergency department and underwent contrast-enhanced computed tomography pulmonary angiography for suspected PE between January 1 and December 31, 2021. In 81/168 patients, the diagnosis of PE was confirmed and in 87/168 it was rejected. The data were analyzed with receiver operating characteristic analysis and binary logistic regression analysis. RESULTS: Patients with PE had a higher white blood cell count (P<0.001), neutrophils (P=0.002), monocytes (P=0.013), neutrophil/lymphocyte ratio (P<0.001), SII (P<0.001), and SIRI (P<0.001), and a lower lymphocyte count (P=0.002). The SII had a sensitivity of 75.31% and a specificity of 71.26%, while the SIRI had a sensitivity of 82.72% and a specificity of 68.97%. Binary logistic regression analysis showed that the Wells score, D-dimer level, and SII independently influenced the diagnosis of PE. CONCLUSION: The SII and SIRI may be used to support the diagnosis of PE in the emergency department.

Physicochemical Properties of Dried and Powdered Pear Pomace.

Pear pomace, a byproduct of juice production, represents a valuable reservoir of bioactive compounds with potential health benefits for humans. This study aimed to evaluate the influence of drying method and temperature on pear pomace, specifically focusing on the drying kinetics, grinding characteristics, color, phenolic profile (LC-MS/MS), and antioxidant activities of the powder. Drying using the contact method at 40 °C with microwave assistance demonstrated the shortest duration, whereas freeze-drying was briefer compared to contact-drying without microwave assistance. Freeze-drying resulted in brighter and more easily comminuted pomace. Lyophilized samples also exhibited higher total phenolic compound levels compared to contact-dried ones, correlating with enhanced antioxidant activity. Twenty-one phenolic compounds were identified, with dominant acids being quinic, chlorogenic, and protocatechuic. Flavonoids, primarily isoquercitrin, and rutin, were also presented. Pear pomace dried via contact at 60 °C contained more quinic and protocatechuic acids, while freeze-dried pomace at the same temperature exhibited higher levels of chlorogenic acid, epicatechin, and catechin. The content of certain phenolic components, such as gallic acid and epicatechin, also varied depending on the applied drying temperature.

Liquid chromatography-tandem mass spectrometry profile and antioxidant, antimicrobial, antiproliferative, and enzyme activities of Thymus pectinatus and Thymus convolutus: in vitro and in silico approach.

BACKGROUND: The objective of this study is to investigate the antiproliferative, antioxidant, antimicrobial, and enzyme activity capacities and phytochemical compositions of Thymus pectinatus (TP), Thymus convolutus (TC), which are endemic to Türkiye. Quantitative analysis of phenolic compounds in the extracts was conducted using liquid chromatography-tandem mass spectrometry, targeting 53 phenolic compounds. RESULTS: Rosmarinic acid, quinic acid, and cynaroside were identified as the major compounds, exhibiting quantitative variation in both extracts. The extracts had a high total phenolic content, with 113.57 ± 0.58 mg gallic acid equivalents (GAE)/g extract for TP and 130.52 ± 1.05 mg GAE/g extract for TC. Furthermore, although both extracts exhibited high total flavonoid content; the TP extract (75.12 ± 1.65 mg quercitin equivalents (QE)/g extract) displayed a higher flavonoid content than the TC extract (30.24 ± 0.74 mg QE/g extract) did. The extracts had a promising antiproliferative effect on C6, HeLa, and HT29 cancer cell lines with a less cytotoxic effect (10.5-14.2%) against normal cells. Both extracts exhibited very potent inhibitory activity against the xanthine oxidase enzyme, with half-maximal inhibitory concentration values of respectively 2.07 ± 0.03 µg mL-1 and 2.76 ± 0.06 µg mL-1 and moderate activity against tyrosinase and α-glucosidase. Docking simulations proved that rosmarinic acid and cynaroside, the major components of the extracts, were the most potent inhibitors of xanthine oxidase. According to antimicrobial activity results, the TC extract exhibited moderate activity against Staphylococcus aureus, and the TP extract had strong activity against both Enterococcus faecium and S. aureus. CONCLUSION: These findings emphasize the beneficial effects of the two endemic Thymus species on human health and suggest their potential use as plant-derived bioactive agents. © 2024 Society of Chemical Industry.

Inhibition of Food-Borne Pathogen Growth and Biogenic Amine Synthesis by Spice Extracts.

Food-borne pathogens and their toxins cause significant health problems in humans. Formation of biogenic amines (BAs) produced by microbial decarboxylation of amino acids in food is undesirable because it can induce toxic effects in consumers. Therefore, it is crucial to investigate the effects of natural additives with high bioactivity like spice extracts to inhibit the growth of these bacteria and the formation of BAs in food. In the present study, the antibacterial effects of diethyl ether spice (sumac, cumin, black pepper, and red pepper) extracts at doses of 1% (w/v) on Gram-positive (Staphylococcus aureus and Enterococcus faecalis) and Gram-negative (Klebsiella pneumoniae, Pseudomonas aeruginosa, Campylobacter jejuni, Aeromonas hydrophila, Salmonella Paratyphi A, and Yersinia enterocolitica) food-borne pathogen bacterial strains (FBP) were established. In addition, the accumulation of ammonia (AMN), trimethylamine (TMA), and biogenic amines (BAs) in tyrosine decarboxylase broth (TDB) was investigated by using high performance liquid chromatography (HPLC). Sumac extract exhibited the highest antibacterial potential against all FBPs, followed by cumin and peppers. AMN (570.71 mg/L) and TMA (53.66 mg/L) production were strongly inhibited by sumac extract in the levels of 55.10 mg/L for Y. enterocolitica and 2.76 mg/L for A. hydrophila, respectively. With the exception of S. aureus, black pepper dramatically reduced the synthesis of putrescine, serotonin, dopamine, and agmatine by FBP especially for Gram-negative ones. Furthermore, sumac extracts inhibited histamine and tyramine production by the majority of FBP. This research suggests the application of sumac extracts as natural preservatives for inhibiting the growth of FBPs and limiting the production of AMN, TMA, and BAs.

LC-ESI-MS/MS analysis of phenolic compounds and in vitro cytotoxicity and apoptosis-inducing effects of Nonea pulmonarioides extracts.

The chemical composition of Nonea pulmonarioides extracts were investigated for the first time. The phytoconstituents of the methanol extracts were screened by using LC/MS-MS technique. The anticancer activity of the acetone and methanol extracts were measured against four cancer cell lines; MCF-7, PC3, HT-29, and U-87 MG. Thirty phenolic compounds were identified, rosmarinic (90.06 mg analyte/g extract) and fumaric acids (39.737 mg analyte/g extract) were major compounds of the studied species. Moreover, both methanol and acetone extracts were found to have strong anticancer activities. The acetone extract HT-29 (with IC50 of 10.17 ± 0.25 µg/mL) compared with standard cis-platin (with IC50 of 22.20 ± 0.72 µg/mL) with apoptotic mediated programmed cell death. These findings identified N. pulmonarioides as a potential species exhibiting anticancer properties. In conclusion, the compelling results show that the methanol extract contains possible bioactive compounds with anticancer properties that require isolation and further characterisation.

The first Turkish family with a novel biallelic missense variant of the ALKBH8 gene: A study on the clinical and variant spectrum of ALKBH8-related intellectual developmental disorders.

ABH8, the protein encoded by the ALKBH8 gene, modifies tRNAs by methylating their anticodon wobble uridine residues. The variations in the ALKBH8 gene are associated with the "intellectual developmental disorder, autosomal recessive type 71" (MIM: 618504) phenotype in the OMIM database. This phenotype is characterized by global developmental delay, facial dysmorphic features, and psychiatric problems. To date, 12 patients from five distinct families carrying variants of the ALKBH8 gene have been reported in the literature. In the present study, we report the first Turkish family harboring a novel homozygous missense variant, NM_138775.3:c.1874G > C (p.Arg625Pro), in the last exon of the ALKBH8 gene. Two affected siblings in this family showed signs of global developmental delay and intellectual disability. Based on the dysmorphological assessment of the cases, fifth finger clinodactyly and fetal fingertip pads were prominent, in addition to the dysmorphic findings similar to those reported in previous studies. Minor dysmorphic limb anomalies in relation to this phenotype have not yet been previously reported in the literature. Our computational studies revealed the potential deleterious effects of the Arg-to-Pro substitution on the structure and stability of the ABH8 methyltransferase domain. In the present report, the first Turkish family with an ultrarare disease associated with the ALKBH8 gene was reported, and a novel deleterious variant in the ALKBH8 gene and additional clinical features that were not reported with this condition have been reported.

Use of encapsulated pomegranate seed oil in novel coarse and nanosized materials for improving the storage life of strawberry.

Different-sized pomegranate seed oil-based emulsions (coarse (CsP) and nanoemulsions (NsP): 1246 and 325 nm) were successfully prepared. Strawberries treated with NsP and CsP showed a significant decrease (p < 0.05) in yeast-mold counts (TMY) by 1.80 log CFU g-1, and mesophilic aerobic bacteria counts (TMAB) decreased (p < 0.05) by 0.91 log CFU g-1, respectively. CsP- and NsP-treated strawberries had a TPC of 74.45 and 82.35 mg GAE kg-1, respectively, while control samples had a TPC of 44.24 mg GAE kg-1. The strawberries treated with NsP exhibited the highest antioxidant capacity with 179.44 mol TEAC g-1. After treatment with a coarse emulsion, severity levels of A. niger and B. cinerea were 60 and 73 % while the nanoemulsion treatment significantly reduced severity levels to 55.3 and 56 %. The coarse and nanoemulsions may have potential use within the food industry owing to their antioxidant and antifungal properties as well as their ability to enhance strawberry quality and function.

Phytochemical characterization and biological activities of Inula viscosa L. Aiton: a promising plant from Turkey.

The methanol extract of Inula viscosa (IVM) was investigated for its antioxidant potential using the DPPH and ABTS radical scavenging as well as iron chelating assays (ICA). The total phenol (TPC) and flavonoid contents (TFC) of IVM were determined using the Folin-Ciocalteu and aluminum trichloride methods, respectively. Antimicrobial activity of different concentrations of I. viscosa methanol extract was investigated by disc diffusion and broth microdilution method. The IVM extract was found to be containing TPC (236.78 ± 7.63 mg GAE/g) and TFC (94.36 ± 1.86 mg QE/g). Antioxidant activity IC50 values for the DPPH, ABTS and ICA assays were found to be 277.7 ± 3.68, 2.44 ± 0.02, and 222.1 ± 0.71 µg/mL, respectively. The MIC values of the IVM on the tested microorganisms ranged from 0.48 to 7.81 mg/mL. Furthermore, IVM extract was demonstrated 18.32 ± 1.37%, 23.06 ± 1.05%, 4.72 ± 0.13%, 15.13 ± 0.37% and 37.64 ± 4.02% inhibition against tyrosinase, α-amylase, α-glucosidase, AChE and BChE, respectively. In the results of LC-MS/MS analysis, acacetin, quercetin, chlorogenic acid and protocatechuic acid were determined as most dominant compounds. These findings suggested that this plant may be a natural resource for creating novel medicinal compounds.

Characterization of phenolic components of black teas of different origins and the effect of brewing duration on quality properties.

This research aims to identify the phytochemical constituents of 79 different samples of black tea, including varieties from India, Iran (IrT), Turkey (TT), and Sri Lanka. In addition, this study investigates the effect of varying brewing times on the quality characteristics of tea. Therefore, we analyzed the phytochemical content of tea using a novel LC-MS/MS method that we developed, which identifies 53 different phenolic compounds. Furthermore, objective evaluations were conducted on the total phenolic compound, total flavonoid compound, antioxidant activity, and color values at 15, 30, and 60-min brewing intervals. The prevailing phenolic compounds discovered in the corresponding tea classifications were quantitatively analyzed to be quinic acid, epicatechin gallate, epigallocatechin gallate, epicatechin, epigallocatechin, gallic acid, nicotiflorine, and isoquercitrin. The study found that the TT and IrT groups had the richest phytochemical content and the highest antioxidant activity. The Turkish tea group had the highest measurement for the desired red color, which is considered a sensory property. Infusion color, antioxidant activity, and total phenolic and flavonoid contents showed significant increases with prolonged brewing time. It was important to note that the chemical composition of tea varies according to its origin and brewing conditions. Extending the brewing time improved the quality of the tea. It should be noted, however, that longer brewing times result in a more intense release of flavonoids, and this increase may have a pro-oxidant effect.

Novel mitochondrial and DNA damaging fluorescent Calix[4]arenes bearing isatin groups as aromatase inhibitors: Design, synthesis and anticancer activity.

Breast cancer causes a high rate of mortality all over the world. Therefore, the present study focuses on the anticancer activity of new lower rim-functionalized calix[4]arenes integrated with isatin and the p-position of calixarenes with 1,4-dimethylpyridinium iodine against various human cancer cells such as MCF-7 and MDA-MB-231 breast cancer cell lines, as well as the PNT1A healthy epithelial cell line. It was observed that compound 6c had the lowest values in MCF-7 (8.83 µM) and MDA-MB-231 (3.32 µM). Cell imaging and apoptotic activity studies were performed using confocal microscopy and flow cytometry, respectively. The confocal imaging studies with 6c showed that the compound easily entered the cell, and it was observed that 6c accumulated in the mitochondria. The Comet assay test was used to detect DNA damage of compounds in cells. It was found that treated cells had abnormal tail nuclei and damaged DNA structures compared with untreated cells. In vitro human aromatase enzyme inhibition profiles showed that compound 6c had a remarkable inhibitory effect on aromatase. Compound 6c displayed a significant inhibition capacity on aromatase enzyme with the IC50 value of 0.104 ± 0.004 µM. Thus, not only the anticancer activity of the new fluorescent derivatives, which are the subject of this study, but the aromatase inhibitory profiles have also been proven.

Investigation of Phytochemical, Antioxidant and Antidiabetic Potentials of Scabiosa L. (Caprifoliaceae) Species with Chemometric Methods.

In this research, the total phenolic and flavonoid amounts, phenolic compositions, in vitro antioxidant, antibacterial and antidiabetic properties of the methanol extracts obtained from Scabiosa L. (Caprifoliaceae) species distributed in the flora of Türkiye were investigated using chemometric methods. For this purpose, principal component (PCA) and agglomerative hierarchical clustering analysis were performed as chemometric methods. Chlorogenic acid, quinic acid and cyranoside were determined in the extracts. According to chemometric analysis, S. columbaria subsp. ochroleuca var. ochroleuca and S. triniifolia species were found to be valuable in terms of methanol extract yields, total phenolic and flavonoid contents, antioxidant and antidiabetic activities while S. columbaria subsp. ochroleuca var. webbiana species were found to be valuable in terms of phenolic composition. The methanol extracts of Scabiosa species showed high antioxidant activity, with high phenolic and flavonoid contents. Among the tested 13 bacteria, Scabiosa extracts showed only low activity against Klebsiella pneumoniae, Streptococcus pneumoniae and Pseudomonas aeruginosa. The extracts showed high α-amylase and α-glucosidase inhibitory activity. The results show that Scabiosa methanol extracts may be a source of alternative antioxidants that may be beneficial in slowing or preventing the progression of various oxidative stress-related diseases.

Optimization of asymmetric bioreduction conditions of 1-indanone by Leuconostoc mesenteroides N6 using a face-centered design-based multi-objective optimization model.

There has been an increasing interest in biocatalysts over the past few decades in order to obtain high efficiency, high yield, and environmentally benign procedures aiming at the manufacture of pharmacologically relevant chemicals. Lactic Acid Bacteria (LAB), a microbial group, can be employed as biocatalysts while performing asymmetric reduction of prochiral ketones. In this study, Leuconostoc mesenteroides N6 was used for the asymmetric bioreduction 1-indanone. And then, a novel and innovative face-centered design-based multi-objective optimization model was used to optimize experimental conditions. Also, the experimental design factors were defined as agitation speed, incubation period, pH, and temperature for optimization to acquire the maximum enantiomeric excess (ee) and conversion rate (cr) values. When using the face-centered design-based multi-objective optimization model, the optimum culture conditions corresponded to 96.34 and 99.42%, ee and cr responses, respectively, were pH = 5.87, incubation temperature = 35 °C, incubation period = 50.88 h, and agitation speed = 152.60 rpm. Notably, the validation experiment under the optimum model conditions confirmed the model results. This study demonstrated the importance of the optimization and the efficiency of the face-centered design-based multi-objective model.

Phytochemical analysis and biological evaluation of Ferulago setifolia K. Koch.

BACKGROUND: Ferulago setifolia K. Koch (Apiaceae) has been the subject of this study, aiming to comprehensively determine its phenolic fingerprint and evaluate its various biological activities. The liquid chromatography-tandem mass spectrometry analysis of the 70% methanol extract of F. setifolia (FS) revealed the presence of 23 phytochemicals, among which chlorogenic acid, quinic acid, kaempferol-3-O-glucoside, and quercetin-3-O-glucoside were identified as the major phenolics in the extract. RESULTS: The biological screening included examinations of antioxidant, antibacterial, antiproliferative, and cytotoxic activities. The FS extract displayed moderate 2,2-diphenyl-1-picrylhydrazyl radical scavenging and ferric-reducing capacity, indicating moderate antioxidant activity. Furthermore, FS exhibited significant antiproliferative effects on cancer cells while showing low cytotoxicity on normal cells. The antibacterial activity findings revealed that FS demonstrated potent activity against Pseudomonas aeruginosa, Bacillus cereus, Staphylococcus aureus, and Escherichia coli. CONCLUSION: The findings of this study suggest that the methanolic extract of FS holds promise as a potential source of biologically active compounds. It can be utilized for the development of pharmaceutical formulations, thanks to its significant antiproliferative and antibacterial activities. Additionally, FS can serve as a valuable source of chlorogenic acid for industrial applications. © 2023 Society of Chemical Industry.

Amidst the clamor: Effects of emergency department noise on Physicians' health and attention.

OBJECTIVE: This study aims to assess effects of noise on physicians' stress levels and attention capacities within an emergency department. METHODS: In this prospective cross-sectional study, 15 physicians from a state hospital emergency department with 300,000 annual visits provided demographics, work factors, and physiologic data. Attention was evaluated through smartphone-based Stroop tests, while noise and heart rates were monitored via smartwatches. RESULTS: Median physician age was 26, with 16 months' emergency department experience. Average sound intensity was 68.80 dB. Despite noise, physicians in green/yellow areas showed increased Stroop scores (p = 0.002). Heart rate responses correlated with noise changes. End-of-shift surveys highlighted physicians' adaptability and resilience to high noise levels. CONCLUSION: Noisy emergency departments pose health risks to physicians, but noise-related stress did not significantly affect attention, beneficial for patient care.

Extensive Skeletal Muscle Metastases in Malignant Pleural Mesothelioma Detected by FDG PET/CT.

Malignant pleural mesothelioma (MPM) is a rare but aggressive tumor originating from pleural mesothelial cells. Distant skeletal muscle metastasis is rare in MPM. A 54-year-old woman was diagnosed with epithelioid MPM and treated with surgery, chemotherapy, and radiotherapy 2 years ago. During follow-up, diffuse irregular pleural thickening with focal chest wall invasion in the right hemithorax and two small pleural thickenings in the left hemithorax were seen on control diagnostic contrast-enhanced computed tomography (CECT). Fluorine-18 fluorodeoxyglucose positron emission tomography/CT (FDG PET/CT) imaging was performed as part of restaging. PET showed diffusely increased FDG uptake in the recurrent right pleural tumor, and two hypermetabolic small metastatic foci in the contralateral pleura. In addition, multiple hypermetabolic areas of various sizes in various skeletal muscle localizations, suggestive of extensive muscle metastases were noted. Histopathologic study confirmed metastatic epithelioid MPM. FDG PET/CT revealed multiple muscle metastases which were not observed on earlier CECT and contributed to the visualization of more extensive metastatic involvements in the presented case with MPM. FDG PET/CT can detect rarely seen skeletal muscle metastases that are not visualized on diagnostic CT, and provides more accurate restaging of MPM.

Effect of Comorbid Diseases on Hospitalization and In-Hospital Mortality of Elderly Patients Who Reapplied to the Emergency Department Within 72 Hours.

OBJECTIVE: This study aimed to determine the effects of comorbidities on hospitalization and in-hospital mortality in patients aged 65 years and older who returned to the emergency department within 24, 48, and 72 hours of an initial visit. METHODS: This study was conducted at the Department of Emergency Medicine, Firat University Faculty of Medicine, Elâzig, Turkey. It has a retrospective design and received local ethics committee approval from the university. Patients aged 65 years and older who presented to the emergency department within a one-year period (2022) were examined to identify those who returned to the emergency department within 24, 48, and 72 hours of an initial visit. RESULTS: A total of 763 (3.2%) patients >65 years of age returned to the emergency department within the first three days of their initial visit. Of these returning patients, 349 returned within 24 hours (Group 1), 227 within 48 hours (Group 2), and 187 within 72 hours (Group 3). Being female, polypharmacy, the presence of at least one comorbidity, cancer, and chronic renal failure were found to be independent predictors of hospitalization, whereas polypharmacy was found to be an independent predictor of in-hospital mortality. CONCLUSION: Patients returning to the emergency department shortly after an initial visit should be assessed more diligently due to the risk of mortality.