Microwave-assisted extraction optimization of sesquiterpene lactones from Inula helenium roots: A sustainable approach to reduce energy consumption and carbon footprint.

Inula helenium roots are consumed as natural flavor components and raw or cooked as food, and their extracts are rich in sesquiterpene lactones such as alantolactone (AL) and isoalantolactone (IAL), which have recently attracted great attention due to their pharmacological properties. The industrial utilization of these compounds requires the development of green, efficient, cost-effective, and sustainable extraction protocols. Therefore, this study focused on the optimization of microwave-assisted extraction (MAE) process variables using Face-Centered Central Composite Design (FC-CCD). Then, maceration was applied as a conventional technique, and these techniques were compared in terms of extraction efficiency, morphological changes, antimicrobial activities, carbon emissions, and energy consumption. As a result, optimal MAE conditions, i.e., EtOH: water ratio (X 1) = 100:0, liquid/sample ratio (X 2) = 30:1 mL/g, microwave power (X 3) = 300 W, and irradiation time (X 4) = 5 min, were obtained with AL and IAL yields of 54.99 ± 0.11 (mg/g) and 48.40 ± 0.19 (mg/g), respectively. The extract obtained by MAE had similar or better activity than positive controls in most cases and formed the largest inhibition zones against E. coli (29.5 ± 0.71 mm) and A. niger (34.75 ± 1.06 mm). Morphological changes of I. helenium roots after extraction were observed by scanning electron microscopy. Additionally, MAE was 43.4 times faster than maceration, resulting in 228.6 times less energy consumption and carbon emissions. Based on these findings, it is recommended to use MAE as an industrial green technique for the extraction of sesquiterpene lactones with potential applications in nutraceuticals and food products in terms of sustainable economy and environmental protection.

Association between syndecan-4 and subclinical atherosclerosis in ankylosing spondylitis.

BACKGROUND: Despite advances in the diagnosis and treatment of ankylosing spondylitis (AS), the risk of cardiovascular complications in AS patients is still higher than in the general population. Macrophages are at the intersection of the basic pathogenetic processes of AS and atherosclerosis. Although syndecan-4 (SDC4) mediates a variety of biological processes, the role of SDC4 in macrophage-mediated atherogenesis in AS patients remains unclear. Herein, we aimed to investigate the role of SDC4 in subclinical atherosclerosis in AS patients. METHODS: Subjects were selected from eligible AS patients and control subjects without a prior history of AS who were referred to the rheumatology outpatient clinics. All participants' past medical records and clinical, and demographic characteristics were scanned. In addition, carotid intima-media thickness (CIMT) measurement and disease activity index measurement were applied to all patients. RESULTS: According to our data, serum SDC4 level was significantly higher among AS patients compared with the control group (6.7 [1.5-35.0] ng/mL vs 5.1 [0.1-12.5] ng/mL, P < .001). The calculated CIMT was also significantly higher in AS patients than in the control group (0.6 [0.3-0.9] mm vs 0.4 (0.2-0.7), P < .001]. Additionally, serum C-reactive protein level and SDC4 level were independent predictors of AS and strongly associated with CIMT. Linear regression analysis showed that serum SDC4 level was the best predictor of CIMT (P = .004). CONCLUSION: Our data indicate that serum SDC4 levels provide comprehensive information about the clinical activity of the disease and subclinical atherosclerosis in AS patients.

Efficacy and safety of endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy and biliary stenting in post-operative bile leaks.

BACKGROUND: We evaluated the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, balloon biliary tract scanning, and plastic stenting in diagnosing and treating bile duct leakage after laparoscopic cholecystectomy and hydatid cyst surgery in this study. METHODS: The study evaluated patients who underwent ERCP, sphincterotomy, and stenting for post-operative bile leakage. The patients were grouped under 4 groups (cystic duct stump, sac bed, hydatid cyst, and choledochal) according to the bile leakage de-tected in the ERCP procedure. The success of the procedure after the ERCP was evaluated by drain extraction time, whether early complications such as bleeding, pancreatitis, and perforation developed due to the ERCP procedure and the presence of obstructive pathology in ERCP. RESULTS: Clinical improvement was observed in 65/73 (89%) patients who underwent successful ERCP procedures, and their drains could be removed. The mean drain removal time was 32.69±23.32 days. After laparoscopic cholecystectomy, bile leakage was most frequently from the cystic duct stump. There was no difference between the groups in procedural success rates. Drain removal time was shorter in the patient group with leakage from the cystic duct compared to the other three groups (P<0.05). After the ERCP procedure, 5/73 (6.9%) patients had minor ERCP complications, which improved with medical treatment. No major ERCP complication was observed. In addition, 25/73 patients (34.2%) had obstructive pathology such as biliary stone and hydatid membrane. CONCLUSION: In patients with biliary leak due to laparoscopic cholecystectomy and hydatid cyst surgery, ERCP, sphincterotomy, balloon scanning, and plastic stenting are both highly effective and reliable options. They should be considered as the first-choice treat-ment approach in this patient group.

The Evaluation of Frailty in the Elderly and Affecting Biopsychosocial Factors: A Cross-Sectional Observational Study.

Background: We aimed to evaluate the frequency of frailty and the affecting factors in people living in our society over 65 yr old. Methods: Our descriptive and cross-sectional study included 261 individuals aged 65 and over who applied to Ankara Training and Research Hospital family practice centers and district polyclinics from 1 Jan to 1 Feb 2020. The participants were asked to complete a sociodemographic data form, FRAIL Scale, Katz Daily Living Activities Scale, Lawton&Brody Instrumental Activities of Daily Living Scale and Geriatric Depression Scale Short Form. Results: According to the FRAIL Scale results: 35 people were found to be frail (13.4%), 115 to be pre-frail (44.1%). No frailty was observed in 111 people (42.5%). While the mean score of the Katz Activities of Daily Living Scale was found to be 5.65±0.71, the mean score of the Lawton&Brody Instrumental Activities of Daily Living Scale was found to be 6.65±1.69. In the geriatric depression evaluation, mild, medium or severe depression was detected in 87 participants (33.2%). As the level of frailty increased, the Geriatric Depression Scale score climbed significantly (P<0.001). In frail individuals, Lawton&Brody Scale scores were significantly lower (P<0.001). In our study: a correlation was found between frailty and female gender, being single, low income, low educational level, obesity, polypharmacy and decreased physical activity. Additionally, as the number of children increase frailty in women increases therewithal. Conclusion: Elderly people had high frailty. Polypharmacy, depression and reduced physical activity were the more frequent in frail elderly. In frail females, the number of children was significantly higher.

Intestinal Peripheral T-Cell Lymphoma in a Patient with Ankylosing Spondylitis Under Treatment with Infliximab: A Case Report and Review of the Literature.

Background: Recent literature involves many cases with lymphoma and ankylosing spondylitis (AS) with or without the use of TNF inhibitors. Herein, we report a patient, a 56-year-old Human Leukocyte Antigen-B27 (HLA-B27) positive man with four years history of AS who was still under treatment with infliximab with clinical remission. He was admitted with a new-onset, 6-week history of bloody diarrhoea with mucus, abdominal pain, fever, and weight loss. An ileocolonoscopy showed linear ileocecal valve ulcers. Histopathological findings of ileocecal valve ulcers revealed peripheral T-cell lymphoma of the small intestine. Infliximab was interrupted because of the possible progression of the lymphoma. Methods: We aimed to emphasize the underlying potential pathogenic mechanisms and to review the related literature. A literature search was conducted in the PubMed database between January 1980 and November 2020. The keywords including 'ankylosing spondylitis' and 'lymphoma' were used. Conclusion: TNFi use, immunosuppression, and chronic inflammation may be related to the development of lymphoma in chronic inflammatory diseases. Ileocecal valve involvement should not be interpreted as inflammatory bowel disease, infection, or vasculitis in the presence of red flags.

Cardiac MRI findings in patients with Crohn's disease.

BACKGROUND: Early cardiac death is more common in patients with Crohn's disease (CD) than in healthy adults, but the exact cause is unknown. AIMS: The aim of this study is to investigate the cardiac magnetic resonance imaging (MRI) findings in patients with CD and compare the MRI findings with healthy controls (HCs). This study also aimed to demonstrate the possible cardiac involvement in patients with CD using MRI. METHODS: In this prospective study, participants with CD (n = 20) and HC (n = 20) underwent cardiac MRI. Erythrocyte sedimentation rate (ESR) and hematocrit levels were investigated before MRI in both groups. Two observers evaluated the ventricular functional and morphological parameters in consensus. Myocardial T1/T2-relaxation times were calculated by two observers independently using two different software, and hematocrit-corrected left ventricle extracellular volume (LV-ECV) was calculated. Observer-2 also performed histogram analysis for T1/T2-mapping images. RESULTS: Patients with CD had a significantly higher LV-ECV, mildly decreased right ventricle ejection fraction, and prolonged T2-relaxation time than HC. Moreover, histogram analysis showed that the maximum and mean T2-relaxation times were higher in patients with CD. There was an excellent agreement between observers for the assessment of mean native and post-contrast T1-relaxation time (intraclass correlation coefficient (ICC) of 0.991 and ICC of 0.941, respectively) and mean T2-relaxation time measurements (ICC of 0.983). Moreover, mean T2-relaxation time was found to be significantly correlated with ESR. CONCLUSIONS: This study suggests visually undetectable myocardial involvement due to chronic systemic inflammation in patients with Crohn's disease. Cardiac MRI can help assess and monitor cardiac involvement in patients with CD.

Investigation of the serum vitamin D level in infants followed up with the diagnosis of laryngomalacia: a case-control study.

OBJECTIVE: The possible etiological relationship of the vitamin D with laryngomalacia is unclear. The aim of the study was to demonstrate the relationship between laryngomalacia and vitamin D levels. METHODS: Twenty-three non-syndromic babies under the age of 1 year who were diagnosed with laryngomalacia were included in the study group. Forty healthy babies were included in the control group. The detailed anamnesis was obtained and a complete systemic physical examination, a flexible endoscopic laryngeal examination, and laboratory tests [calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), parathormone (PTH), alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), creatinine (Cre), and 25-hydroxy vitamin D (25-OH D)] were performed in all patients. All laboratory tests of the groups were compared. RESULTS: It was observed that there was no significant difference in the parameters that could affect vitamin D levels, namely type of feeding, vitamin D supplement intake, and the season when the serum sample was taken (p > 0.05). The vitamin D level was significantly lower (p = 0.003, p < 0.05) and the P and ALP levels were significantly higher (p = 0.016 and p = 0.001, respectively; p < 0.05) in the laryngomalacia group. Although the correlation between vitamin D and PTH was not statistically significant according to the Pearson correlation analysis, it was lower in the laryngomalacia group compared to the control group (p = 0.381, p > 0.05). CONCLUSION: In this study, it was observed that the vitamin D levels were lower in infants with laryngomalacia compared to the control group. We consider that vitamin D deficiency may be a factor in the etiology of laryngomalacia with a yet-to-be-clarified etiology.

Serum omentin-1 levels in hypertensive patients.

Hypertension (HT) is a disease that can cause death due to multiple target organ damage and eventually related vascular system damage. High blood pressure is known increased inflammatory activity and to cause endothelial dysfunction has been showed in HT patients. Omentin-1 is a glucoprotein of the adiponectin family released from visceral adipose tissue, endothelial cells, and visceral fat stromal-vascular cells. It has anti-inflammatory effect and circulating omentin-1 concentration correlates negatively with waist circumference, insulin resistance, and body-mass index. Serum omentin-1 is used as a biomarker of coronary artery disease, obesity, cancer, metabolic syndrome, inflammatorydisease, atherosclerosis, and diabetes mellitus. The aim of our study is to investigate circulating omentin-1 levels in HT patients compared to healthy normotensive controls. Patients diagnosed with new essential HT (n = 61) and healthy normotensive individuals (n = 60) were enrolled in this study. The HT group was separated into two subgroups. There were 30 patients in stage 2 HT group and 31 patients in stage 1 HT group. Omentin-1 levels were significantly lower both in stage 1 and 2 HT subgroup as compared with the normotensive controls (72.19 ± 54.33 ng/ml for stage 1 HT subgroup; 62.45 ± 47.01 ng/ml for stage 2 HT subgroup; and, 147.84 ± 58.55 ng/ml for healthy normotensive controls; overall P < 0.001). The present study demonstrated that serum Omentin-1 levels decreased in patients with HT compared with normotensive controls. These lower concentrations may be attributed to a combined outcome of endothelial dysfunction, renal injury, and inflammation in the setting of hypertension.

Prognostic value of thiol/disulfide homeostasis in symptomatic patients with heart failure.

We aimed to examine the role of thiol/disulphide homeostasis (TDH) in heart failure and its stages and the prognosis of heart failure. A total of 140 subjects were included in the study. Total and native thiol levels were higher in the control group compared to the patient groups (p < .001). While the average disulphide/total thiol ratio was similar in groups 1 and 2, it was found to be significantly lower in the control group compared to other groups and significantly higher in group 3 compared to other groups (p < .05). Mean native thiol and total thiol levels were found lower in patients with mortality compared to surviving patients (p < .001). In ROC curve analysis, it was determined that the total thiol level had 81.8% sensitivity and 83.1% specificity, and native thiol level had 81.8% sensitivity and 84.3% specificity. We found that TDH was impaired in favour of disulphide in cases of heart failure.

Nesfatin-1 Levels Predict Angiographic No-Reflow in Patients with ST-Segment Elevation Myocardial Infarction.

BACKGROUND: Nesfatin-1 is a novel peptide possessing pleiotropic metabolic effects. No-reflow phenomenon (NR) is a poor prognostic indicator occurring in around 30% of all patients undergoing primary percutaneous coronary interventions (pPCI). Inflammation and complexity of coronary artery disease (CAD) play pivotal roles in the pathogenesis of NR. In this study, we investigated the relationship between admission serum nesfatin-1 level, NR and complexity of CAD assessed by SYNTAX-1 (SS-1) and SYNTAX-2 (SS-2) scores in patients with ST-segment elevation myocardial infarction (STEMI) undergoing pPCI. METHODS: A total of 174 STEMI patients who underwent pPCI were included in the study and divided into NR (n = 36) and normal flow (n = 138) groups. Serum nesfatin-1 was measured by enzyme-linked immunosorbent assay. Seventy-eight consecutive age-, gender- and co-morbidity-matched patients undergoing coronary angiography with < 50% stenosis comprised the control group. RESULTS: Nesfatin-1 levels were significantly lower in the NR group compared to the normal flow and control groups (10.8 ± 6.6 ng/mL vs. 34.9 ± 24 ng/mL vs. 43.6 ± 23.2 ng/mL, respectively, p < 0.001). Nesfatin-1 was significantly and inversely correlated with SS-1 and SS-2 scores (r = -0.709 and r = -0.655, respectively, both p < 0.001). Multivariate logistic regression analysis showed that nesfatin-1 [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.708-0.936, p = 0.004] and glomerular filtration rate (OR = 0.94, 95% CI = 0.892-0.989, p = 0.018) were independently associated with NR. In the receiver operating characteristic analysis, nesfatin-1 < 15.21 ng/mL predicted NR with 78.4% sensitivity and 72.2% specificity (area under the curve = 0.809, 95% CI = 0.701-0.918, p < 0.001). CONCLUSIONS: Admission nesfatin-1 level is a potent predictor of NR in STEMI patients undergoing pPCI. Additionally, nesfatin-1 has a robust and negative correlation with the complexity of CAD.

Increases in retinal nerve fiber layer thickness may represent the neuroprotective effect of cannabis: an optical coherence tomography study.

Although optical coherence tomography (OCT) has been used in many neuropsychiatric disorders, data on substance use disorders (SUD) are not available. The aim of this study was to evaluate ganglion cell layer (GCL), inner plexiform layer (IPL), retinal nerve fiber layer (RNFL), and choroidal layer thickness in patients diagnosed with SUD especially cannabis use disorder (CUD). RNFL, GCL, IPL, and the choroidal layers of 111 patients diagnosed with SUD and 45 healthy controls were retrospectively analyzed. Fifty patients were diagnosed with CUD and 50 patients had multiple drug use (MDU). The mean age of the patient and control groups were 23.39 ± 5.53 and 28.48 ± 5.21 years, respectively. The mean duration of substance use was 3.53 ± 2.95 years. The patients had not used any substance for a mean of 121.45 ± 116.99 days. When the RNFL values of the SUD, MDU, and control groups were compared, no significant difference was found except for such components. However, there were significant differences in terms of right naso-superior (p = 0.020), right temporo-inferior (p = 0.024), right temporo-superior (p = 0.002), left naso-superior (p = 0.005), left naso-inferior (p = 0.043), and left temporo-superior (p = 0.008) between CUD and control groups. That is, RNFL values were higher in the CUD group than in the control group. Cannabis has medical uses because of its possible neuroprotective properties. Our study supports the possible neuroprotective effects associated with cannabis through RNFL data. According to our best knowledge, this is the first study investigating the association between RNFL and drugs, particularly cannabis.

Prognostic Value of Inflammation Parameters in Patients With Non-ST Elevation Acute Coronary Syndromes.

Inflammation parameters can predict the severity of coronary artery disease and predict long-term mortality. However, there is no study in which these parameters were evaluated together. We compared the prognostic values of inflammation parameters in predicting long-term mortality in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Consecutive patients with NSTE-ACS (n = 170) were included in the study. Monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), total cholesterol/HDL-C ratio (TC/HDL-C), triglyceride /HDL-C ratio (TG/HDL-C), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index, and ischemia-modified albumin (IMA) were measured. Total antioxidant status and TOS variables were significant independent predictors of mortality. When 1.17 value is taken as a cutoff point of TAS values, the sensitivity (70.0%) and specificity (77.39%) values calculated for this value indicate that TAS variable has a predictive value on mortality. Monocyte/high-density lipoprotein cholesterol ratio, LMR, NLR, PLR, TC/HDL-C, TG/HDL-C, TOS, and IMA levels could not be used alone in the diagnosis, severity assessment, and predicting future mortality of NSTE-ACS. Only TAS levels had a predictive value on mortality.

Wet Cupping Therapy Improves the Parameters of Ventricular Repolarization.

BACKGROUND: Cupping therapy (CT) is an ancient medical treatment since antiquity and is used for the treatment of such various disease states as contagious diseases, chronic or acute inflammatory disease, and autoimmune disorders. Ventricular repolarization is represented by QT and corrected-QT (QTc) intervals from surface electrocardiography. OBJECTIVES: As novel repolarization parameters, Tpeak-toTend (Tp-Te) interval, and Tp-Te/QT and Tp-Te/QTc ratios are suggested to correlate better with ventricular arrhythmia risk in various clinical conditions than sole QT and QTc intervals. In this study, we aimed to determine whether these parameters changed significantly after CT in healthy individuals. METHODS: One hundred and twenty participants (57 women and 63 men; mean age: 49.0 ± 13.0 years) participated in this study. ECGs strips were recorded 1 hour before and 1 hour after CT from each participant, and relevant ECG parameters were compared. RESULTS: Tp-Te interval [69.51 ± 11.54 msec vs 63.15 ± 10.89 msec, p = 0.001], Tp-Te/QT ratio [0.191 ± 0.030 vs 0.174 ± 0.031, p = 0.002] and Tp-Te/QTc ratio [0.175 ± 0.030 vs 0.159 ± 0.026, p = 0.001] were found to be significantly decreased 1 hour after the procedure compared with the pre-procedure values. However, no statistically significant change was observed in mean heart rate, QT and QTc intervals, QT/QRS and cQT/QRS, and frontal QRS/T angle after the procedure compared with the same parameters before the procedure (p > 0.05). CONCLUSIONS: In accordance with the results of our study, it is plausible to conclude that CT may exert cardioprotective effect. However, larger scale prospective studies are needed to support our findings.

Impact of the Angles of the Septal Deviation on the Degree of the Mastoid Pneumatization.

INTRODUCTION: The aim was to explore the developmental relationships between the angles of septal deviations and the degree of the mastoid pneumatization. MATERIALS AND METHODS: In total, 143 patients with a diagnosis of septal deviation who underwent septoplasty were included. The patients were divided into three groups in terms of the angles of the septal deviation. The angle of the septal deviations was defined as mild (<9 degrees), moderate (between 9 and 15 degrees) and severe (15 degrees and above). The degree of the mastoid pneumatization of each groups were compared. RESULTS: In right-sided septal deviation subjects, the right mastoid air cell volumes of group mild, moderate and severe were 6,31±2,33 cm3, 5,20± 1,51 cm3, and 5,31±1,57 cm3, respectively. The mean right mastoid volumes of each groups did not differ in right-sided deviations subjects (P>0.05). The mean left mastoid volumes of each groups did not differ in right-sided deviations subjects (P>0.05). In right-sided septal deviation subjects, the mean volume of the right and left-sided mastoid air cells of each groups did not differ (P>0.05). In left-sided septal deviation subjects, the mean volume of the right and left-sided mastoid air cells of each groups did not differ (P>0.05). CONCLUSIONS: No developmental relationships between the angles of septal deviations and the degree of the mastoid pneumatization was observed in the study.

Effect of Anesthesia Applied for Magnetic Resonance Imaging on the Body Temperature of Pediatric Patients.

Objective Anesthesia may be required to ensure the immobility of the patient during a magnetic resonance imaging (MRI) scan, particularly in pediatric patients. An MRI scanner generates radiofrequency radiation (RFR) to obtain images of parts of the body. During an MRI procedure, an amount of RFR is transformed into heat by the body, thereby leading to increased body temperature. However, patients are at increased risk of hypothermia due to the impairment of thermoregulation by anesthesia and the cold and dry environment of the MRI room. The aim of this study was to investigate the effects of anesthesia on body temperature with regard to patient safety in pediatric patients undergoing an MRI scan. Materials and methods The study included a total of 40 children aged three to 10 years who underwent an MRI procedure. The patients were divided into two groups based on the administration of anesthesia: (I) non-sedated and (II) sedated. Prior to the procedure, non-sedated patients were informed about the procedure by a psychiatrist. Body temperature was measured from the tympanic membrane and skin in each patient. The MRI scan was performed at room temperature (20°C-22°C) with a relative humidity of 35%-40%. Results No significant change was found between pre- and post-scan body temperatures in Group I, whereas a significant decrease was found between pre- and post-scan body temperatures in Group II. No complication occurred in any patient due to temperature change or anesthesia. Conclusion A significant decrease in body temperature was found in pediatric patients undergoing an MRI procedure under sedation. The results implicated that anesthesia has a remarkable effect on the balance between the temperature increase caused by RFR and the temperature decrease caused by anesthesia.

Anatomical Factors in Children with Orbital Complications Due to Acute Rhinosinusitis.

INTRODUCTION: The role of the anatomical variations and severity of acute rhinosinusitis (ARS) in the development of ARS complications is still an unknown issue. Regarding this, the present study evaluated the relationship between the severity of ARS and anatomical nasal variations in pediatric patients with ARS-related orbital complications. MATERIALS AND METHODS: This study was conducted on 134 pediatric patients with orbital complications related to ARS. The data related to patients' demographics, complication types, and involved side were collected. Nasal sides were also compared in terms of the Lund-Mackay score (LMS), osteomeatal complex (OMC) obstruction, Keros classification, presence of agger nasi cells (AGC), concha bullosa, Haller cells, Onodi cells, septal deviation, and lower turbinate hypertrophy. RESULTS: The comparison of LMSs indicated a significant difference between the complicated and contralateral sides (8.37±2.44 vs. 5.62±2.71; P<0.0001). In addition, there was a significant difference between the complicated and contralateral sides in terms of the OMC scores (P<0.0001). The rates of lower turbinate hypertrophy and AGC on the complicated side were higher than those on the contralateral side (P=0.021 and P<0.00; respectively). CONCLUSION: As the results indicated, anatomical variability in adjacent structures affects the development of ARS-related orbital complications in pediatric patients.

Plasma-Free Amino Acid Profiling of Nasal Polyposis Patients.

AIM AND OBJECTIVE: To determine the mechanisms present in the etiopathogenesis of nasal polyposis. It is not clear whether amino acids contribute in a causal way to the development of the disease. Therefore, the aim of this study was to determine the plasma-free amino acid profile in patients with nasal polyposis and to compare the results with a healthy control group. MATERIALS AND METHODS: This was a prospective controlled study that took place in the Otolaryngology Department at the Harran University Faculty of Medicine between April 2017 and April 2018. Plasmafree amino acid profile levels were studied in serum samples taken from a patient group and a healthy control group. Patients who were diagnosed with bilateral diffuse nasal polyposis and were scheduled for surgical interventions were included in this study. Individuals whose age, gender, and body mass index values were compatible with that of the patient group and who did not have any health problems were included in the control group. All the participants whose levels of plasma-free amino acid were thought to be affected by one or more of the following factors were excluded from the study: smoking and alcohol use, allergic rhinitis presence, the presence of acute or chronic sinusitis, a history of endoscopic sinus surgery, unilateral nasal masses, a history of chronic drug use, systemic or topical steroid use in the last three months for any reason, and liver, kidney, hematological, cardiovascular, metabolic, neurological, or psychiatric disorders or malignancies. RESULTS: In patients with nasal polyposis, 3-methyl histidine (3-MHIS: nasal polyposis group (ng) = 3.22 (1.92 - 6.07); control group (cg) = 1.21 (0.77 - 1.68); p = 0.001); arginine (arg: ng = 98.95 (70.81 - 117.75); cg = 75.10 (54.49 - 79.88); p = 0.005); asparagine (asn: ng = 79.84 (57.50 - 101.44); cg = 60.66 (46.39 - 74.62); p = 0.021); citrulline (cit: ng = 51.83 (43.81 - 59.78); cg = 38.33 (27.81 - 53.73); p = 0.038); cystine (cys: ng = 4.29 (2.43 - 6.66); cg = 2.41 (1.51 - 4.16); p = 0.019); glutamic acid (glu: ng = 234.86 (128.75 - 286.66); cg = 152.37 (122.51 - 188.34); p = 0.045); histidine (his: ng = 94.19 (79.34 - 113.99); cg = 74.80 (62.76 - 98.91); p = 0.018); lysine (lys: ng = 297.22 (206.55 - 371.25); cg = 179.50 (151.58 - 238.02); p = 0.001); ornithine (ng = 160.62 (128.36 - 189.32); cg = 115.91 (97.03 - 159.91); p = 0.019); serine (ser: ng = 195.15 (151.58 - 253.07); cg = 83.07 (67.44 - 92.44); p = 0.001); taurine (tau: ng = 74.69 (47.00 - 112.13); cg = 53.14 (33.57 - 67.31); p = 0.006); tryptophan (trp: ng = 52.31 (33.81 - 80.11); cg = 34.44 (25.94 - 43.07); p = 0.005), homocitrulline (ng = 1.75 (1.27 - 2.59); cg = 0.00 (0.00 - 0.53); p = 0.001); norvaline (ng = 6.90 (5.61 - 9.18); cg = 4.93 (3.74 - 7.13); p = 0.021); argininosuccinic acid (ng = 14.33 (10.06 - 25.65); cg = 12.22 (5.77 - 16.87) p = 0.046); and plasma concentrations were significantly higher than in the healthy control group (p <0.05). However, the gamma-aminobutyric acid (gaba: ng = 0.16 (0.10 - 0.24); cg = 0.21 (0.19 - 0.29); p = 0.010) plasma concentration was significantly lower in the nasal polyposis group than in the healthy control group. CONCLUSION: In this study, plasma levels of 15 free amino acids were significantly higher in the nasal polyposis group than in the healthy control group. A plasma level of 1 free amino acid was found to be significantly lower in the nasal polyposis group compared to the healthy control group. Therefore, it is important to determine the possibility of using the information obtained to prevent the recurrence of the condition and to develop effective treatment strategies. This study may be a milestone for studies of this subject. However, this study needs to be confirmed by further studies conducted in a larger series.

Relationship of growth differentiation factor-15 with aortic stiffness in essential hypertension.

AIM: We aimed to assess the relationship between echocardiographic parameters of aortic elasticity, namely aortic strain, aortic distensibility and aortic ß-index, and serum growth differentiation factor (GDF)-15 in patients with newly diagnosed essential hypertension (HT). METHODS: Grade-1 HT patients (n = 50), grade-2 HT (n = 70) patients and 35 healthy controls were included. RESULTS: GDF-15 was greater in grade-2 HT group compared with the other groups. All aortic elasticity parameters were worse in grade-2 HT group compared with the other groups. GDF-15 correlated positively with E/E' ratio (the ratio of transmitral E velocity to mean diastolic mitral annular velocity) and ß-index; and aortic strain and aortic distensibility correlated negatively with serum GDF-15. ß-index, aortic diastolic diameter and diastolic blood pressure were independently associated with GDF-15. CONCLUSION: GDF-15 may be utilized in the prediction of increased aortic stiffness.

Usefulness of white blood cell count to mean platelet volume ratio in the prediction of SYNTAX score in patients with non-ST elevation myocardial infarction.

OBJECTIVE: White blood cell (WBC) count to mean platelet volume (MPV) ratio (WMR) is associated with major adverse cardiovascular events in patients with non-ST elevation acute coronary syndrome (NSTEMI). We aimed to compare WMR between NSTEMI patients and matched-controls and to evaluate its predictive value on SYNTAX score. METHODS: Total 175 patients with NSTEMI and 160 age and co-morbidity matched subjects were recruited in our study. WMR was compared between the patient and control groups. The patient group was further subdivided into 3 tertiles according to SYNTAX scores as follows: low SYNTAX score tertile (score ≤22, 141 patients); intermediate SYNTAX score tertile (score between 23 and 32, 20 patients); and, high SYNTAX score tertile (score ≥33, 14 patients). WMR was further assessed among the tertiles. RESULTS: WMR was significantly greater in the patient group compared to the control group (p<0,001). WMR among low, intermediate and high score tertiles were calculated to be 890±26, 1090±042 and 1500±65, respectively (p <0,001). In receiver operating characteristics (ROC) analysis, WMR >960 predicted a SYNTAX score ≥23 with 80.6% sensitivity and 67.6% specificity (AUC: 0.756; 95% CI: 0.685 - 0.818; p <0.0001) and a WMR >1360 predicted a SYNTAX score ≥33 with 71.4% sensitivity and 93% specificity (AUC: 0.840; 95%CI: 0.777 - 0.892; p <0.0001). CONCLUSIONS: WMR value was significantly elevated in NSTEMI patients, compared to controls. Higher WMR was associated with greater SYNTAX score in patients with NSTEMI. WMR may be used to predict severity of the CAD and to implement risk stratification in patients with NSTEMI.