The effect of ileal resection length on postoperative complications and prognosis in right colon cancer.

BACKGROUND: There is a lack of literature on the length of the terminal ileum to be resected in right hemicolectomy for colon cancer. Therefore, we aimed to determine the mean ileal loop length and the effect of this variation on postoperative complications and long-term oncological outcomes in patients who underwent right hemicolectomy. METHODS: Right hemicolectomy surgeries performed for colon cancer in a tertiary care hospital between January 2011 and December 2018 were retrospectively analyzed from a prospective database. Two patient groups were established based on the mean length of the resected ileum above and below 7 cm. The two groups were compared for clinicopathological data, postoperative complications, mortality, long-term overall survival (OS) and disease-free survival (DFS). The factors contributing to OS and DFS were analyzed. RESULTS: The study included 217 patients. Body mass index (BMI) values were significantly higher in the ileum resection length > 7 cm group (p = 0.009). Pathological N stage, tumor diameter, and number of metastatic lymph nodes were significantly higher in the ileum resection length > 7 cm group (p = 0.001, p = 0.001, and p = 0.026, respectively). There was no significant difference for postoperative complication and mortality rates between the two groups. The mean follow-up period was 61.2 months (2-120) in all patients. The total number of deaths was 29 (11.7%) while the 60-month OS was 83.5% and 50-month DFS was 81.8%. There was no significant difference between the groups in terms of OS and DFS rates (p > 0.05). CONCLUSIONS: Excessive resection of the distal ileum in right hemicolectomy does not provide any benefit in terms of prognosis and complications.The ileum resection length and values close to it in our study appear to be sufficient.

Evaluation of Rretracted Aarticles in the field of emergency medicine on the web of science database.

BACKGROUND: The retraction of articles stands as the most significant mechanism employed to uphold the integrity of science, particularly in flawed studies. OBJECTIVES: This study aims to explore the reasons for article retractions in the field of emergency medicine and elucidate the problems arising from such retractions. The goal is to identify parameters in retracted articles that compromise scientific knowledge and raise awareness. MATERIAL AND METHODS: Retracted articles within the emergency medicine category were analyzed and assessed using the Web of Science database. The study sought to address the following questions: 1. In which year or years were the most articles retracted? 2. In which journals were the retracted articles published? 3. What is the distribution of topics in retracted articles? 4. What are the reasons for the retraction of articles? 5. What is the time difference and citation count between the publication and retraction years of the articles? RESULTS: The study delved into reasons for article retractions, types of retracted articles, and other relevant factors. A total of 61 retracted articles were examined and analyzed, revealing an increasing trend in the rate of article retractions over the years. The majority of retracted articles occurred in 2023, with the highest retraction rate identified in the "Emergency Medicine International" journal. On average, articles were retracted 356 days after publication. Reasons for retracted articles included concerns related to data, authorship issues, plagiarism, duplication, and biased or fraudulent peer review. CONCLUSIONS: This study provided an examination of retracted articles in the field of emergency medicine, highlighting a noteworthy increase in retractions due to various reasons. Despite retractions, it was observed that the citation counts of retracted articles increased. The growing number of retracted articles and frequent citations pose potential dangers from a scientific perspective, as citing retracted articles damages scientific integrity. The study underscores the importance of understanding the reasons for retracted articles and preventing the spread of such incidents in emergency medicine literature. The results, analyzed within various variables, indicate the need for further research and solutions, guiding future research efforts and contributing to the literature.

Greater Socioeconomic Disadvantage as Measured by the Area Deprivation Index Is Associated With Failure of Healing Following Arthroscopic Repair of Massive Rotator Cuff Tears but Not With Clinical Outcomes.

PURPOSE: To analyze the relationship between Area Deprivation Index (ADI) and preoperative status and short-term postoperative clinical outcomes among patients who underwent arthroscopic rotator cuff repair (ARCR) of massive rotator cuff tears (MRCTs). METHODS: A retrospective review was conducted on prospectively maintained data on patients who underwent ARCR of MRCTs defined as tear size ≥5 cm or complete tear of at least 2 tendons, with a minimum 2-year follow-up and a valid home address between January 2015 and December 2018. Each patient's home address was mapped to the ADI to determine neighborhood disadvantage. This composite index is composed of 17 census-based indicators, including income, education, employment, and housing quality to quantify the level of socioeconomic deprivation. Ratings were recorded and categorized based on the sample's percentile. Patients were then divided into 2 groups: upper quartile (ie, most disadvantaged [≥75th percentile]) and lower 3 quartiles (ie, least disadvantaged [<75th percentile]). Bivariate analysis was performed to associate ADI with patient-reported outcomes (PROs) and range of motion pre- and postoperatively, as well as complications, healing rate, satisfaction, and return to work. Patients reaching or exceeding the minimal clinically important difference for visual analog scale (VAS), American Shoulder and Elbow Surgeons, Veterans Rand 12-Item questionnaire, and subjective shoulder value were recorded for both cohorts. RESULTS: Ninety-nine patients were eligible for study analysis. Preoperative PROs and range of motion were similar, except for a greater VAS for pain (6.3 vs 4.3; P < .01) and lower American Shoulder and Elbow Surgeons score (32.2 vs 45.1; P = .01) in the most disadvantaged group. Both groups showed similar postoperative PROs scores, but greater VAS improvement was seen in the upper quartile group (Δ 4.2 vs Δ 3.0; P = .04). In contrast, only the least-disadvantaged group significantly improved in internal rotation (P = .01) and forward flexion (18°; P < .01) from baseline. Although satisfaction, complications, and return to work were comparable (P > .05), failure of healing occurred more frequently in the most disadvantaged group (21% vs 6%; P = .03). CONCLUSIONS: Patients with MRCTs residing in the most disadvantaged neighborhoods as measured by the ADI have more pain and functional limitations before undergoing ARCR but demonstrate similar postoperative functional improvements to patients from other socioeconomic backgrounds. Failure of healing of MRCTs may be more common in disadvantaged groups. Furthermore, both groups reported similar rates of clinically important functional improvement. LEVEL OF EVIDENCE: Level III, retrospective cohort comparison.

Comparison of oncological and functional results of robotic and open perineal radical prostatectomy.

OBJECTIVE: We aimed to compare the functional and oncological outcomes of patients who underwent open perineal radical prostatectomy (OPP) and robotic perineal radical prostatectomy (RPP) for prostate cancer (PCa). METHODS: The data of patients who underwent OPP and RPP from June 2016 to February 2019 due to localized PCa were analyzed. Demographic characteristics, perioperative data and oncological results of the patients were recorded. In addition, the incontinence status of the patients immediately after catheter removal and at the 3rd, 6th, and 12th months were compared. Potency status was evaluated among the patients with preoperative potency, and 12th month potency status was compared. RESULTS: A total of 135 patients were included, of whom 58 (43%) were in the OPP group and 77 (57%) were in the RPP group. The operation time was statistically significantly shorter in the OPP group (83.90 ± 15.48 vs. 110.88 ± 28.10 min, p = 0.001). The amount of bleeding was significantly lower in the RPP group (59.51 ± 22.04 vs. 74.06 ± 17.66, p = 0.002). The continence rates evaluated at the early period, 3rd, 6th, and 12th months were 40.3%, 80.5%, 87.0%, and 90.9%, respectively, for the RPP group and 36.2%, 70.7%, 86.2%, and 89.7%, for the OPP group, indicating no statistically significant difference (p > 0.05). There was no statistically significant difference in the 12th month rates of postoperative potency according to the surgical technique (p > 0.05). CONCLUSION: Although differences were observed between the OPP and RPP techniques in terms of perioperative parameters, oncological and functional results were similar.

The Anti-Apoptotic Effect of Ranolazine on Cerebral Protection during Cardiopulmonary Bypass and Carotid Artery Surgery.

Background: We aimed to determine the usability of ranolazine (Rn) as a neuroprotective during cardiac surgeries and carotid artery interventions where cerebral blood flow is interrupted. Methods: Female Wistar albino rats were used. The rats were divided into 4 groups of 8 rats each. The first group (Group 1) was the control group. Group 2 underwent ischemia induction but was not treated with Rn. Group 3 received 25 mg/kg/day and Group 4 50 mg/kg/day Rn intraperitoneally, starting 3 days before ischemia induction. Bilateral carotid arteries were explored and clamped simultaneously. Ischemia was induced for 15 minutes. After 72 hours, the experimental animals were sacrificed. Results: Superoxide dismutase, alkaline phosphatase, and interleukin 6 levels were similar among the 4 groups. Acetylcholine esterase (Group 3: p = 0.007, Group 4: p = 0.002), tumor necrosis factor-alpha (Group 4: p = 0.01), and annexin V (Group 3: p = 0.001) levels were statistically significantly lower in the Rn-treated groups. Malondialdehyde (Group 3: p = 0.003, Group 4: p = 0.009), reduced glutathione (Group 4: p = 0.04), acid phosphatase (Group 3: p = 0.04), noradrenaline (Group 3: p = 0.01), and Bcl-2 (Group 4: p = 0.004) levels were significantly higher in the Rn-treated groups. Conclusions: The results of this study demonstrated the antiapoptotic effect of Rn in a brain ischemia-reperfusion model of rats receiving Rn before the procedure.

Association between oxygen delivery and digital ulcers in systemic sclerosis.

OBJECTIVE: Tissue hypoxia due to microvasculopathy is the main cause of digital ulcers (DUs) in systemic sclerosis (SSc). Reduced oxygen delivery (DO2) to the tissues may also contribute to the development of DU. This study was conducted to investigate the association between DO2 and DUs in patients with SSc. METHODS: In all, 111 patients and 30 healthy controls were enrolled. DO2 was calculated by using the formula; DO2 = Cardiac output × arterial oxygen saturation (SpO2) × serum haemoglobin level × 1.39 × 10. Both right index finger SpO2 measurements (index-SpO2) and highest value of SpO2 (maximum SpO2) obtained among the fingers of the subjects were used for the calculations and DO2 results were adjusted both for weight and body surface area (BSA). RESULTS: Mean DO2 was lower in SSc patients as compared to controls in all 4 different calculations but the difference was only statistically significant when using index-SpO2 and adjusting for BSA (498 mL/min/m2 vs 549 mL/min/m2, p = 0.03). There was a strong positive correlation between cardiac output and DO2 calculated by using the index-SpO2 (r = 0.903; p < 0.001). Of the SSc patients, 46 (41.4 %) had DUs within the last 12 months. Patients with DUs had higher mean mRSS, lover mean FVC and more frequently diffuse disease, interstitial lung disease, anti-SCL70 antibody positivity (p < 0.05 for all). No difference was observed in DO2 among DU positive or DU negative groups by any calculation (p > 0.05 for all). CONCLUSIONS: DO2 in SSc patients seems to be lower than healthy controls. However, DO2 is similar between the patients with and without DUs. Our results suggest that the contribution of DO2 is negligible to the development of DU and support the major role of microvasculopathy in SSc patients with DUs.

Insight into potent TLR2 inhibitors for the treatment of disease caused by Mycoplasma pneumoniae based on machine learning approaches.

Mycoplasma pneumoniae (MP) is one of the most common pathogens that causes acute respiratory tract infections. Children experiencing MP infection often suffer severe complications, lung injury, and even death. Previous studies have demonstrated that Toll-like receptor 2 (TLR2) is a potential therapeutic target for treating the MP-induced inflammatory response. However, the screening of natural compounds has received more attention for the treatment of bacterial infections to reduce the likelihood of bacterial resistance. Herein, we screened compounds by combining molecular docking and machine learning approaches to find potential lead compounds for treating MP infection. First, all compounds were docked with the TLR2 receptor protein to screen for potential candidates. To predict drug bioactivity, a machine learning model (random forest) was trained for TLR2 inhibitors to obtain the predictive model. The model achieved significant squared correlation coefficient (R2) values for the training set (0.85) and validation set (0.84) of compounds. The developed machine learning model was then used to predict the pIC50 values of the top 50 candidates from the Traditional Chinese compounds and Discovery Diversity sets of compounds. As a result, these compounds are capable of inhibiting the inflammatory response induced by MP. However, prior to bringing these compounds to market, it is necessary to verify these results with additional biological testing, including preclinical and clinical studies. Moreover, the present study provides a theoretical basis for the use of natural compounds as potential candidates to treat pneumonia caused by MP.

Single or Combined Valve Surgery and Concomitant Right Coronary Artery Bypass through Right Anterior Minithoracotomy Approach.

BACKGROUND: Patients with combined valve and coronary artery disease are commonly performed by standard median sternotomy approach for coronary artery bypass grafting (CABG) and valve surgery. The purpose of this study is to describe our experience and show feasibility and safety of minimally invasive approach to single or combined valve pathology with single-vessel right coronary artery (RCA) disease, even if it is suitable to percutaneous coronary intervention. METHODS: This retrospective study comprised 28 consecutive patients who underwent single or combined valve surgery concomitant right CABG through right anterior minithoracotomy between February 2018 and December 2020. Preoperative evaluation, intraoperative, and postoperative outcomes were reviewed and analyzed. RESULTS: There were 12 men and 16 women. The mean age was 71.46 ± 6.82 years. Ten patients were in New York Heart Association class III or IV. The mean cardiopulmonary bypass and aortic cross-clamping times were 117.6 ± 21.3 and 98.1 ± 22.6 minutes, respectively. The mean time to extubation was 9.7 ± 5.6 hours, the mean intensive care unit stay was 37.4 ± 14.6 hours, and the mean hospital stay was 6.9 ± 3.2 days. There was one patient who underwent reoperation for bleeding. There were no instances of postoperative stroke, myocardial infarction, renal failure, or wound infection. The mean follow-up was 19 ± 2.4 months. CONCLUSION: Presence of RCA lesion is not a contraindication for minimally invasive approach in cases who underwent single or combined valve surgery. Combined valve surgery and right CABG via right anterior minithoracotomy are a safe and feasible option to standard median sternotomy surgery, even if RCA lesions seem suitable for stenting.

Higher Upper Subscapularis Goutallier Grade and Coracohumeral Distance Narrowing Are Predictive of Subscapularis Tears in Patients Undergoing Arthroscopic Rotator Cuff Repair.

PURPOSE: To evaluate the relation between subscapularis (SSC) Goutallier grade or coracohumeral distance (CHD) and SSC tears, as well as the relation between these radiographic variables and long head of the biceps tendon lesions. METHODS: A retrospective analysis was conducted on prospectively maintained data on patients who underwent arthroscopic rotator cuff repair of SSC tears between 2011 and 2021 with at least 6 months of follow-up. Patients with identified subscapularis tears during arthroscopy were included. A control group was established by randomly selecting patients without SSC tears from the same study period. Goutallier grading and CHD were obtained from preoperative magnetic resonance imaging (MRI) scans. Receiver operating characteristic analysis was conducted to define optimal cutoff values for these diagnostic measures. RESULTS: The study included 735 patients with SSC tears and 249 patients in the control group. Comparing subscapularis tear and intact groups' Goutallier grades revealed significant differences in infraspinatus, upper and lower SSC, and overall SSC (P < .001). No significant difference was detected in supraspinatus Goutallier grade (P = .364). An SSC tear was observed in 58.3% (n = 265) of patients with Goutallier grade 0 of the upper SSC, 77.1% (n = 195) of patients with grade 1 changes, 98.7% (n = 155) with grade 2 changes, and 100% of grade 3 or 4 changes. Goutallier grade of the upper SSC showed a significant correlation with tear size (rs = 0.533; P < .01). CHD measurements were lower in individuals with SSC tears compared to those without tears (6.6 ± 1.7 vs 9.6 ± 1.8; P < .001). Upper SSC Goutallier grade >1 had an acceptable area under the curve (AUC) of 0.742. CHD of 7.96 mm or less had an excellent predictive AUC of 0.879. CONCLUSIONS: Higher Goutallier grade and CHD narrowing are potential associations predictive of SSC tears. Routine MRI assessment of muscle of the upper SSC and the CHD can contribute to the diagnostic accuracy of SSC tears and offer valuable information regarding the severity of such tears. LEVEL OF EVIDENCE: Level III, diagnostic study.

Adaptation of the professionalism mini-evaluation exercise instrument into Turkish: a validity and reliability study.

BACKGROUND: There is an ongoing search for standardized scales appropriate for each culture to evaluate professionalism, which is one of the basic competencies of a physician. The Professionalism Mini-evaluation Exercise (P-MEX) instrument was originally developed in Canada to meet this need. In this study, it was aimed to adapt the P-MEX to Turkish and to evaluate the validity and reliability of the Turkish version. METHODS: A total of 58 residents at Bakirkoy Dr. Sadi Konuk Training and Research Hospital were assessed with the Turkish version of P-MEX by 24 raters consisting of faculty members, attending physicians, peer residents, and nurses during patient room visits, outpatient clinic and group practices. For construct validity, the confirmatory factor analysis was performed. For reliability, Cronbach's alpha scores were calculated. Generalizibility and decision studies were undertaken to predict the reliability of the validated tool under different conditions. After the administration of P-MEX was completed, the participants were asked to provide feedback on the acceptability, feasibility, and educational impact of the instrument. RESULTS: A total of 696 forms were obtained from the administration of P-MEX. The content validity of P-MEX was found to be appropriate by the faculty members. In the confirmatory factor analysis of the original structure of the 24-item Turkish scale, the goodness-of-fit parameters were calculated as follows: CFI = 0.675, TLI = 0.604, and RMSEA = 0.089. In the second stage, the factors on which the items loaded were changed without removing any item, and the model was modified. For the modified model, the CFI, TLI, and RMSEA values were calculated as 0.857, 0.834, and 0.057, respectively. The decision study on the results obtained from the use of P-MEX in a Turkish population revealed the necessity to perform this evaluation 18 times to correctly evaluate professionalism with this instrument. Cronbach's alpha score was 0.844. All the faculty members provided positive feedback on the acceptability, feasibility, and educational impact of the adapted P-MEX. CONCLUSION: The findings of this study showed that the Turkish version of P-MEX had sufficient validity and reliability in assessing professionalism among residents. Similarly, the acceptability and feasibility of the instrument were found to be high, and it had a positive impact on education. TRIAL REGISTRATION: 2020/249, Bakirkoy Dr. Sadi Konuk Training and Research Hospital.

Patients 75 years or older with primary glenohumeral arthritis and an intact rotator cuff show similar clinical improvement after reverse or anatomic total shoulder arthroplasty.

BACKGROUND: The optimal management of primary glenohumeral arthritis (GHOA) in the elderly is an ongoing topic of debate. The purpose of this study was to compare functional outcomes and complications in patients aged 75 years or older treated with anatomic total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA) for primary GHOA with an intact rotator cuff. METHODS: A retrospective study was performed on a prospectively maintained database which was queried for patients 75 years of age or older who underwent TSA or RSA for primary GHOA with an intact rotator cuff at a single institution between 2012 and 2021 with minimum 2-year follow-up. Patient-reported outcomes (PROs), including Visual Analog Scale for pain, American Shoulder and Elbow Surgeons, and Subjective Shoulder Value, as well as active range of motion including forward flexion, external rotation, internal rotation, were collected preoperatively and postoperatively. Complications, reoperations, and satisfaction were also recorded. The percentage of patients achieving clinically significant improvement was evaluated with the minimally clinical important difference, substantial clinical benefit, and patient acceptable symptomatic state for each PRO. RESULTS: One-hundred and 4 patients were available for analysis, including 67 TSA patients and 37 RSAs with a mean follow-up of 39.4 months. Preoperative baseline characteristics, PROs, and range of motion were similar between groups. RSA was more commonly performed for eccentric glenoid wear (Walch B2/B3, 62% vs. 22%; P < .001). While clinical outcomes improved comparably in both groups, the TSA cohort showed significantly greater improvement in external rotation (36° vs. 26°; P = .013). Both cohorts had low revision (3% for TSA vs. 0% for RSA) and complication (7% for TSA vs. 5% for RSA; P = .677) rates. Satisfaction was similar in both groups (93% for TSA vs. 92% for RSA; P = .900). Clinically significant improvement was comparable between groups based on the American Shoulder and Elbow Surgeons score (minimally clinical important difference, 93% for TSA vs. 100% for RSA; substantial clinical benefit, 82% vs. 95%; patient acceptable symptomatic state, 67% vs. 78%; P > .05). CONCLUSION: In this retrospective small sample size comparison study, TSA and RSA provide similar short-term clinical outcomes for patients 75 years and older with primary GHOA and an intact rotator cuff. Complication and revision rates are comparably low at short-term follow-up. Our data suggests that advanced age alone should not be used as a decision-making tool for TSA vs. RSA in the setting of primary GHOA with an intact rotator cuff.

A Critical Analysis of the Magnetic Resonance Imaging Lesion Diameter Threshold for Adverse Pathology Features.

To investigate the relationship between lesion size determined using multiparametric magnetic resonance imaging (mpMRI) and histopathological findings of specimens obtained after mpMRI fusion biopsy and radical prostatectomy (RP). We retrospectively analysed 290 patients with PCa who underwent an MRI fusion biopsy. We measured the diameter of suspicious tumour lesions on diffusion-weighted mpMRI and stratified the cohort into two groups. Group A included patients with a suspicious tumour lesion 10 mm and Group B included those with a suspicious tumour lesion > 10 mm. In Group B, the PI-RADS score determined in mpMRI was higher than Group A, and there was a statistically significant difference between the two groups in terms of clinical T-stage. The PCa detection rate and the number of positive cores were statistically significantly higher in Group B than in Group A. In addition, there was a statistically significant difference between the two groups in relation to the biopsy, the International Society of Urological Pathology (ISUP) grade values, and the presence of clinically significant PCa. In Group B, pathological T-stage and extraprostatic extension (EPE) and surgical margin (SM) positivity were found to be higher among the patients who underwent RP. In the multivariate analysis, the mpMRI lesion size being > 10 mm was found to be an independent predictive factor for SM and EPE positivity. The clinical results of this study support the modification of the lesion size threshold as 10 mm for use in the differentiation of PI-RADS scores 4 and 5.

Prediction of infective complications after retrograde intra renal surgery using Machine learning.

BACKGROUND: To compare the models obtained with classical statistical methods and machine learning (ML) algorithms to predict postoperative infective complications (PICs) after retrograde intrarenal surgery (RIRS). MATERIAL AND METHODS: Patients who underwent RIRS between January 2014 and December 2020 were retrospectively screened. Patients who did not develop PICs were classified as Group 1 and patients who developed as Group 2. RESULTS: Three-hundred and twenty-two patients were included in the study; 279 patients (86.6%) who did not develop PICs were classified as Group 1, and 43 patients (13.3%) who developed PICs were classified as Group 2. In multivariate analysis, the presence of diabetes mellitus, preoperative nephrostomy, and stone density were determined to be factors that significantly predicted the development of PICs. The area under the curve (AUC) of the model obtained by classical Cox regression analysis was 0.785, and the sensitivity and specificity were 74% and 67%, respectively. With the Random Forest, K- Nearest Neighbour, and Logistic Regression methods, the AUC was calculated as 0.956, 0.903, and 0.849, respectively. RF's sensitivity and specificity were calculated as 87% and 92%, respectively. CONCLUSION: With ML, more reliable and predictive models can be created than with classical statistical methods.

Pulmonary hypertension in Behçet's disease: echocardiographic screening and multidisciplinary approach.

BACKGROUND: Little is known about the prevalence and causes of pulmonary hypertension (PH) in Behçet's disease (BD). This study was conducted to determine the prevalence and causes of PH in BD. METHODS: In this descriptive study, we screened 154 patients with BD for PH using transthoracic echocardiography between February 2017 and October 2017. An estimated systolic pulmonary arterial pressure (sPAP ≥ 40 mmHg) was used as the cutoff value to define PH. Patients with BD were categorized into 5 groups according to organ involvement including mucocutaneous/ articular, ocular, vascular, gastrointestinal, and neurologic involvement. Additional laboratory and imaging results were obtained from hospital file records to determine the causes of PH. RESULTS: PH was detected in 17 (11%) patients. Nine (52.9%) of these patients had group II PH (due to left heart disease), 4 (23.5%) had IV PH (due to pulmonary arterial involvement), and 1 had III PH (due to chronic obstructive lung disease). The frequency of PH was higher in BD patients with vascular involvement than those without (52.9% vs 28.5%; p = 0.04). Among 10 patients with pulmonary artery involvement (PAI) 4 (40%) had PH. Although the vascular BD group had the highest rate of PH, we observed no statistically significant difference in the frequency of PH between the predefined BD subgroups. DISCUSSION: : PH is not rare in patients with BD. The majority of BD patients with PH are in group II or IV PH. Patients with vascularinvolvement carry a higher risk for the development of PH. Monitoring BD patients with PAI should be considered for the development of group IV PH.

The impact of antiphospholipid antibodies in Takayasu arteritis.

BACKGROUND: The significance of antiphospholipid antibodies (aPL) is controversial in Takayasu arteritis (TA). This study was conducted to explore the frequency of aPL and their association with disease-related complications in TA. METHODS: : This cross-sectional study was conducted to investigate the presence of anti-cardiolipin (aCL), anti-beta 2 glycoprotein- 1(aß2G1) antibodies, and lupus anticoagulant (LA) in TA patients. TA patients admitted to the Department of Rheumatology of Hacettepe University Faculty of Medicine between December 2015 and September 2016 who fulfilled the American College of Rheumatology (ACR) classification criteria for TA were consecutively enrolled in the study. Patients were grouped according to aPL positivity and compared in terms of disease manifestations, type of vascular involvement at diagnosis, and vascular complications/interventions attributable to TA. RESULTS: Fifty-three TA (49 female) patients were enrolled in the study. We detected 9 (16.9%) patients with IgM and/or IgG aß2G1 and/or LA positivity. There were no patients with positive aCL. All aß2G1 titers were low. There were no differences in terms of symptoms, signs, type of vascular involvement, the number of patients with disease-related complications or vascular interventions/surgery between aPL (+) and aPL(-) groups (p > 0.05 for all). The number of patients with thrombotic lesions was similar between the groups (p > 0.05). There were no patients with a history of venous thrombosis or on anticoagulant treatment in the aPL(+) group. Only 1 patient with IgM aß2G1 (+) had a history of pregnancy loss. DISCUSSION: Our results indicate that aPL positivity is not rare in TA. On the other hand, all aPL titers were low and no differences were found in the frequency of disease-related complications between aPL(+) and aPL(-) patient groups. Only TA patients with atypical manifestations with high suspicion of aPL-related complications should be considered to be investigated for aPL.

Differences and similarities of proliferative and non-proliferative forms of biopsy-proven lupus nephritis: Single centre, cross-disciplinary experience.

OBJECTIVE: We aimed to compare clinical features, outcomes, treatments, and to define the predictive factors of complete renal response (CRR) in patients with proliferative and non-proliferative lupus nephritis (LN). METHODS: Patients with systemic lupus erythematosus (SLE) followed between 2014 and 2020 at Hacettepe University Hospitals and who had a kidney biopsy were the subject of the study. One hundered and sixteen patients' kidney biopsies reported as LN were evaluated retrospectively. Clinical characteristics and laboratory values at the time of kidney biopsy, histopathological forms of LN, and renal response (complete or partial) were recorded. We analyzed the association between CRR rates during the 2-year follow-up after induction therapy and the predictive factors for CRR. RESULTS: Of 116 (93 females, 23 males) patients, 95 (81.9%) were in the proliferative group (class III and IV) and 21 (18.1%) were in the non-proliferative group (class II and V). In the proliferative group, the percentage of the patients with elevated basal creatinine levels, median daily proteinuria, anti-double-stranded DNA (dsDNA) positivity, low C3 and C4 levels, the presence of active urinary sediment, and median renal SLE Disease Activity Index (SLEDAI) scores at the time of kidney biopsy were significantly higher than the non-proliferative group. Renal response status during the 2-year follow-up after induction therapy was available for 99 patients. During this time, 70 (70.7%) patients had achieved CRR and time-to-CRR was similar between the proliferative and non-proliferative groups (p = 0.64, log-rank test). The Cox proportional hazards model showed that achievement of CRR was associated with female gender [HR: 2.15 (1.19-3.89 95% CI), p = 0.011], newly diagnosed SLE with renal biopsy [HR: 2.15 (1.26-3.67 95% CI), p = 0.005], hypertension [HR: 0.40 (0.27-0.94 95% CI), p = 0.032], eGFR increase [HR: 1.01 (1.00-1.01 95% CI), p = 0.046], and the presence of active urinary sediment [HR: 0.46 (0.22-0.96 95% CI), p = 0.039]. CONCLUSIONS: Achieving CRR was similar in proliferative and non-proliferative LN patients, although certain laboratory parameters differed at the onset. Our results indicated the importance of kidney biopsy in the decision-making of treatment of SLE patients with renal involvement and that the defined factors associated with CRR achievement help to predict good renal response.

Is the impact of biologic agents in enteropathic spondylitis different from other spondylitis? Real life data from the HUR-BIO Registry.

OBJECTIVES: To compare enteropathic spondylitis (ES) with psoriatic spondylitis (PS) and ankylosing spondylitis (AS), in patients on biological disease-modifying anti-rheumatic drug (bDMARD) treatment. METHODS: Patients who were enrolled in the HUR-BIO registry were included. ES patients were considered as the main study group; AS and PS patients were included as the control groups. ES was defined as patients with inflammatory bowel disease (IBD) having inflammatory back pain/spine symptoms plus radiological sacroiliitis. RESULTS: Sixty-four ES patients (46.9% female), 128 AS patients (39.1% female), and 92 PS patients (62% female) were analysed. Baseline erythrocyte sedimentation rate (ESR) was significantly higher in the ES group than in the AS group. Both the baseline ESR and C-reactive protein were also higher in the ES group compared with the PS group. Among the first bDMARD use, infliximab use was higher in the ES group than the other groups. There was a marginal significant difference between the SpA subgroups in the retention rates of the first bDMARDs (log-rank, p=0.059). Ulcerative colitis was a significant predictor for switching of bDMARDs in comparison to Crohn's disease. Regarding the treatment responses, no significant differences were relevant for the three groups in terms of 50% improvement of the initial Bath Ankylosing Spondylitis Disease Activity Index score, the Assessment of Spondyloarthritis International Society partial remission score, and 20% improvement of ASAS score. CONCLUSIONS: A large majority of enteropathic spondyloarthritis patients on bDMARD treatment had radiographic sacroiliitis. ES patients had distinctive features that distinguish them from AS and PS patients.

In vivo biocompatibility evaluation of 3D-printed nickel-titanium fabricated by selective laser melting.

Nickel-titanium (NiTi) belongs to the group of shape-memory alloys (SMAs), which are characterized by flexibility and reversible deformability. Advanced techniques in 3D printing by selective laser-melting (SLM) process allow the manufacturing of complex patient-specific implants from SMAs. Osteosynthesis materials made of NiTi could be used for minimally invasive surgical approaches in oral- and maxillofacial surgery. However, the in vivo biocompatibility has not yet been fully investigated, especially in load-sharing and load-bearing implants. The aim of this study was to evaluate the in vivo biocompatibility of SLM-produced NiTi for intraosseous and subperiosteal applications. Test specimens were implanted into the frontonasal bone of ten miniature pigs. To assess peri-implant bone metabolism, fluorescent dye was administered after 2, 4, 6, 10, 12, and 14 weeks intraperitoneally. Specimens and the surrounding tissues were harvested after 8 and 16 weeks for histological analysis. While the NiTi implants presented a higher bone-to-implant contact ratio (BIC) after 8 than after 16 weeks (43.3 vs. 40.3%), the titanium implants had a significantly higher BIC after 16 weeks (33.6 vs. 67.7%). Histologically, no signs of peri-implant inflammation or foreign-body reaction were detectable. With respect to this preliminary study design, 3D-printed NiTi shows sufficient biocompatibility for intraosseous and subperiosteal implant placement.

Testicular salvage: using machine learning algorithm to develop a predictive model in testicular torsion.

PURPOSE: To compare the models developed with a classical statistics method and a machine learning model to predict the possibility of orchiectomy using preoperative parameters in patients who were admitted with testicular torsion. MATERIALS AND METHODS: Patients who underwent scrotal exploration due to testicular torsion between the years 2000 and 2020 were retrospectively reviewed. Demographic data, features of admission time, and other preoperative clinical findings were recorded. Cox Regression Analysis as a classical statistics method and Random Forest as a Machine Learning algorithm was used to create a prediction model. RESULTS: Among patients, 215 (71.6%) were performed orchidopexy and 85 (28.3%) were performed orchiectomy. The multivariate analysis revealed that monocyte count, symptom duration, and the number of previous Doppler ultrasonography were predictive of orchiectomy. Classical Cox regression analysis had an area under the curve (AUC) 0.937 with a sensitivity and specificity of 88 and 87%. The AUC for the Random Forest model was 0.95 with a sensitivity and specificity of 92 and 89%. CONCLUSION: The ML model outperformed the conventional statistical regression model in the prediction of orchiectomy. The ML methods are cheap, and their powers increase with increasing data input; we believe that their clinical use will increase over time.

The presence of Toxoplasma gondii in soil, their transmission, and their influence on the small ruminants and human population: A review.

The ecosystem approach has been developed since the 1940s. An ecosystem is a community of living organism and their interaction and conjugation with abiotic factors of the environment. The ecosystem is not endemic to the aquatic environment only but, the terrestrial environment is also considered to be a part of an ecosystem. Soil act as mother role for the survival of different microorganism. The Toxoplasma gondii oocysts stay survive for a long time in the soil. This presence of these oocysts might critically enhance the success of this parasite in two ways. First, this parasite can widespread; second, it can create a lot of consequences regarding animals and their economic value. Soil contamination caused by Toxoplasma gondii Y is a significant and profound issue for animals and public health. Therefore, the current study was aimed to summarize and correlate the soil and parasite, their transmission, infection, and some aspects related to T. gondii. The small animals are pose at a high risk therefore, it was concluded that some preventive measures should be taken to keep secure itself from zoonotic diseases.