The place of B-mode ultrasonography, shear-wave elastography, and superb microvascular imaging in the diagnosis of De Quervain tenosynovitis.

PURPOSE: Superb microvascular imaging (SMI) and Shear wave elastography (SWE) are newly developed ultrasonographic diagnostic tools used to support the diagnosis of De Quervain tenosynovitis (DQT). The aim of this study was to examine the capacity to differentiate between the wrist with DQT and the healthy wrist, as well as the potential for predicting the disease's severity using B-mode ultrasonography, SWE, and SMI. METHODS: A total of 19 cases with unilateral clinical DQT were included in the prospective study. The wrists of these cases without DQT clinic constituted the control group. RESULTS: The SWE parameters of m/s and kPa cutoff values were ≤5.225 and ≤ 77.65, respectively, in the wrists with DQT compared to the wrists not diagnosed with DQT (p < 0.001). Regarding SMI findings no microvascularity was determined in the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon sheaths of the wrists without DQT, and a significant increase was observed in the degree of microvascularity as the clinical severity of DQT increased. CONCLUSION: SWE results can differentiate between the presence and absence of DQT. SMI grading of the APL and EPB tendon sheaths may be helpful to the clinician in deciding the clinical severity of DQT.

Possible relationship between IL28B rs12979860 and TLR2 -196 to -174 del/ins polymorphisms and the liver fibrosis stage in hepatitis C patients.

It has been shown that host factors play an important role in the progression of hepatitis C virus (HCV) infection. Toll-like receptor 2 (TLR2) del and interleukin 28B (IL28B) T alleles can mediate liver inflammation and pathogenesis of hepatocellular carcinoma. In the present study, the possible relationship between the IL28B rs12979860 C/T and TLR2 -196 to -174 del/ins gene variants and different fibrosis stages and host factors in hepatitis C patients was investigated. IL28B and TLR2 polymorphisms in the blood of 50 hepatitis C patients at different stages of fibrosis (24 mild/moderate, 26 advanced) and 24 healthy controls were examined by RT-qPCR. The highest frequency of the TLR2 del (26.9%) and IL28B T (46.2%) alleles was found in hepatitis C patients with the most advanced fibrosis, and the lowest frequency was found in healthy controls. There was a statistically significant difference between hepatitis C patients with advanced fibrosis and healthy controls in terms of the TLR2 del (p = 0.0062) and IL28B T (p = 0.0017) allele frequencies. However, no statistically significant difference was found between the mild/moderate fibrosis and severe fibrosis patient groups in terms of genotype or IL28B and TLR2 polymorphisms (p > 0.05). In addition, there was a significant difference between patients with mild/moderate or advanced fibrosis who carried the TLR2 del allele together with the IL28B CT genotype and healthy controls. The present study emphasizes that the TLR2 and IL28B gene variants cannot be single biomarkers for the determination of fibrosis stage in hepatitis C infection but together can play an important role in predicting severe disease.

hsa-miR-17-5p: A Possible Predictor of Ombitasvir/Paritaprevir/Ritonavir + Dasabuvir ± Ribavirin Therapy Efficacy in Hepatitis C Infection.

Although persistent sustained viral response rates are increased in hepatitis C infection following administration of direct-acting antiviral (DAA) agents, the pre-use predictive parameters of these antivirals and the clinical progression in patients post-treatment remain unknown. To obtain data pertaining to the predictive parameters prior to the use of ombitavir/paritaprevir/ritonavir + dasabuvir and the clinical progression in patients following antiviral treatment. The expression profiles of miR-223-3p, miR-17-5p, miR-24-3p, and TLR2 - 196 to - 174 del/ins polymorphisms from the blood/serum of 34 hepatitis C virus (HCV)-infected patients pre- and post-ombitavir/paritaprevir/ritonavir + dasabuvir treatment were determined by RT-qPCR. The expression levels of miR-17-5p (P < 0.001) and miR-24-3p (P = 0.011) were significantly downregulated post-treatment as compared with those pre-treatment; however, there was no significant difference between these two groups in terms of miR-223-3p expression. In addition, there was no significant difference in TLR2 genotype or allele distribution between pre-and post-treatment (P > 0.05); nevertheless, the TLR2 del allele was decreased post-treatment (16.2%) as compared with that pre-treatment (19.1%), although the difference was not statistically significant. Moreover, a significant difference was found between the mRNA levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and HCV RNA pre-and post-treatment (P < 0.05). Further, miR-17-5p expression correlated with both ALT and AST mRNA levels post-treatment (P.

Comparison of Two Scoring Systems in Pediatric Open Globe Injuries.

PURPOSE: The aim of this study is to determine the demographic characteristics of pediatric open globe injuries, evaluate the ocular trauma scores (OTS), and predict the visual outcomes. METHODS: All patients with pediatric open globe injuries who applied to Department of Ophthalmology, Faculty of Medicine, Mersin University between January 2018 and December 2019 were included in this study. Age, gender, type of injury, time of admission, time to surgery, OTS, and pediatric ocular trauma score (POTS) were calculated for each patient. The relation between these findings and final visual acuity (VA) after 12 months of follow-up was examined. RESULTS: Forty-two eyes of 41 patients were included in this study. The most common injuries observed were sharp objects such as knives (23.8%) and stones (23.8%). The wound locations were zone I in 36 patients (85.7%) and zone II in 6 patients (14.3%). The most common concomitant eye pathologies were iris prolapse in 37 (88.1%) and hyphema in 29 (69.1%). The mean original OTS was 77.21 and the mean POTS was 46.78. Association between OTS/POTS and final VA was very good (Kendall Tau-b = 0.665, P < 0.001, Kendall Tau-b = 0.505, P < 0.001, respectively). The level of agreement between the predicted VA for OTS and that for POTS was almost perfect (kappa = 0.8726). CONCLUSIONS: This study shows that the original OTS is still the gold standard in pediatric cases.

Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6-8 years: A randomized experimental study.

PURPOSE: This study aimed to compare the effects of bubble-blowing (active distraction) and cartoon watching (passive distraction) techniques on pain, anxiety, and fear during venipuncture in children aged 6-8 years. DESIGN AND METHODS: This experimental study randomly assigned 56 children aged 6-8 years to cartoon watching or bubble-blowing groups. The child, parent, and researcher assessed pain using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children's State Anxiety Scale, and fear using the Children's Fear Scale. The study data were analyzed using the Chi-square tests and independent Sample t-tests. RESULTS: The groups were similar in clinical and demographic characteristics. The scores on pain, anxiety, and fear during the procedure were lower in the cartoon watching group than in the bubble-blowing group (pain t(47) = 2.638, p = .013; anxiety t(47) = 2.358, p = .023; and fear t(47) = 2.784, p = .008). CONCLUSION: This study revealed that cartoon watching as a passive distraction method was more effective in reducing pain, anxiety, and fear during venipuncture in children aged 6-8 years compared to bubble-blowing as an active distraction method. PRACTICE IMPLICATIONS: The cartoon watching technique, which is affordable, easy to access, and effective (in reducing pain, anxiety, and fear), can be safely used during venipuncture in children aged 6-8 years.

The role of CD1a expression in the diagnosis of cutaneous leishmaniasis, its relationship with leishmania species and clinicopathological features.

Cutaneous leishmaniasis is caused by a flagellated protozoan transmitted by the bite of a female sandfly. The clinical and demographic details of this disease, predominantly affecting immunocompetent individuals, are recognized by the WHO as a Neglected Tropical Disease. We sought to determine the usability of CD1a immunohistochemical staining to detect amastigotes especially in cases where leishmaniasis is suspected but evident amastigotes could not observed. We also evaluated the relationship between CD1a expression and leishmania subtypes. A total of 84 cases diagnosed with leishmaniasis or suspected leishmania on histo-morphological evaluation of skin biopsies were included in the study. Amastigotes were easily detected in hematoxylin eosin in 18 of 84 cases. In 23 cases, amastigotes could not detect in hematoxylin eosin sections. The immunostains for CD1a are demonstrated amastigotes in 60 of 84 cases. However, a small number of amastigotes became visible by positive staining with CD1a in 43.4% of the cases in that amastigotes could not detected in hematoxylin eosin. A statistically significant correlation was found between amastigote amount in hematoxylin eosin and CD1a expression. In addition, a significant correlation was observed between CD1a expression, age and clinical pre-diagnosis of the cases. It was observed that amastigotes were easily detected in hematoxylin eosin in Leishmania Infantum / donovani positive cases in polymerase chain reaction (PCR), and at the same time, it was found that CD1a expression was significantly higher. Using histopathology examination with CD1a staining and/or PCR methods, a diagnosis of leishmaniasis can be established and early treatment initiated. This contributes to reduce transmission and prevalence.

Thiol/Disulfide Balance in Older Patients with BCR-ABL Negative Myeloproliferative Neoplasms.

BACKGROUND: The trio Essential Thrombocytosis (ET), Polycythemia Vera (PV), and Primary Myelofibrosis (PM) are BCR-ABL negative myeloproliferative neoplasms. All three diseases have the risk of transforming into acute leukemia. Oxidative stress and some genetic mutations increase the risk of leukemic transformation. The median age in patients with ET, PV, and MF is around 64 years, and it is expected to exceed 65 in the coming years. Since oxidative stress increases with age, we aimed to evaluate the oxidative stress parameters in older patients with myeloproliferative neoplasms. METHODS: The study included a total of 160 patients (57 patients with Essential Thrombocytosis, 52 patients with Primary Myelofibrosis, and 51 patients with Polycythemia Vera) and 56 healthy controls, aged 65 and over. Ischemia Modified Albumin (IMA) and thiol parameters (native thiol, total thiol, and disulfide) were studied from serum samples taken at the time of diagnosis. RESULTS: The median age of the patients was 69 (65 - 85) years. Patients had higher levels of IMA and lower levels of thiol compared to the control group (p < 0.001). When evaluated according to disease subgroups, it was observed that the highest IMA levels and the lowest thiol levels were in patients with PM (p < 0.001). Higher IMA levels and lower native thiol levels were found in patients with the ASXL1 mutation (p < 0.001). CONCLUSIONS: Serum IMA and thiol levels are also significantly changed in older patients with BCR-ABL negative myeloproliferative neoplasia. Changes in these markers are independent of age. Disease-associated mutations such as ASXL1 can also affect the serum levels of these markers.

The Usefulness of Platelet Distribution Width and Platelet Distribution Width to Lymphocyte Ratio in Predicting Severity and Outcomes in Patients with Snakebite.

INTRODUCTION: Tissue damage, inflammatory response, and hematologic abnormalities may occur in snakebite envenomation. This study aimed to evaluate the predictive ability of platelet distribution width (PDW) and platelet distribution width to lymphocyte ratio (PDWLR) in the severity and outcome of envenomation in patients with snakebites in the emergency department (ED). METHODS: All adult patients admitted to the ED after a snakebite were retrospectively evaluated. Patients were classified according to the severity of envenomation. The relationship between the PDW and PDWLR and envenomation severity and patient outcomes was analyzed. Multivariate logistic regression analysis was performed to determine the predictors of severe envenomation. Results were presented as 95% CIs with odds ratios. Statistical significance was accepted at P<0.05. RESULTS: Envenomation was classified as none/minimal in 42 patients and moderate/severe in 29. PDW and PDWLR were significantly higher in the moderate/severe group (P=0.016 and P<0.001, respectively). Cut-off values of 16.5 for PDW and 6.15 for PDWLR were related to more severe envenomation (area under the curve 0.67, 95% CI 0.55-0.78 and area under the curve 0.85, 95% CI: 0.74-0.92, respectively). Blood product replacement, thrombocytopenia, hematologic abnormality, advanced local findings, compartment syndrome/fasciotomy, antivenom dosing, and moderate/severe envenomation were associated with PDWLR >6.15 (P<0.05). In multivariate analysis, PDWLR (odds ratio 1.19 [95% CI 1-1.4]; P=0.04) was an independent predictor of severe envenomation. CONCLUSIONS: Higher PDW and PDWLR were associated with severe envenomation in patients with snakebites in the ED. PDWLR may be used as a predictor of severe envenomation and adverse outcomes.

Characteristics of the patients who admitted to the emergency department with seizures and the factors affecting the frequency of admission.

OBJECTIVES: To determine the features of patients applying to the emergency department (ED) with seizures and the factors affecting the frequency of admission. METHODS: This study was designed as a retrospective, cross-sectional study. The demographic and clinical characteristics, admission frequencies, diagnostic tests (laboratory and imaging methods) of the patients who were older than 18 years old and admitted to the ED between January 1, 2014 and January 1, 2017 with seizures were analyzed. RESULTS: The study included 867 patients with seizures. A comparison of the number of admissions by gender revealed a statistical significance (p=0.007). The number of admissions and the number of seizures until the time of admission were compared and found a statistical significance (p=0.002). In the logistic regression analysis of the factors affecting the frequency of admissions, seizure character [OR: 4.404 (%95 CI:1.761-11.015), p=0.002], comorbidity [OR: 2.021 (%95 CI:1.407-2.904), p<0.001], hospitalization [OR:1.893 (%95 CI: 1.259-2.847), p=0.002], concomitant injury [OR: 2.013 (%95 CI: 1.016-3.988), p=0.045], drug use (p<0.001), and possible etiology cerebrovascular disease (CVD) [OR: 2.763 (%95 CI: 1.327-5.752), p=0.007] were risk factors for frequent admission of patients applying to ED with seizures. CONCLUSION: Seizure character (first and known seizure), comorbidity status, hospitalization, concomitant injury, anti-epileptic drugs use, and possible etiology CVD are risk factors affecting the frequency of admission with seizure.

Evaluation of Ocular Complications by Using Optical Coherence Tomography in Children With Sickle Cell Disease Eye Findings in Children With Sickle Cell Disease.

OBJECTIVE: The aim of this study was to compare optical coherence tomography (OCT) findings in pediatric patients with sickle cell disease (SCD) and healthy individuals and to investigate associations between these data and the patients' systemic findings. MATERIALS AND METHODS: The study included 108 eyes of 54 patients with SCD with no visual symptoms and a control group consisting of 110 eyes of 55 healthy subjects with no systemic or ocular pathology. After best-corrected visual acuity assessment, the study participants underwent a complete ophthalmologic examination including intraocular pressure. After examination and pupil dilation induced with 1% tropicamide, 9×9 mm macular sections were obtained with spectral-domain OCT. The macular sections were evaluated according to Early Treatment Diabetic Retinopathy Study (ETDRS) map and internal and external retinal thicknesses were measured using the software included in the OCT device. RESULTS: The patient group showed significantly more foveal flattening, temporal thinning, and vascular tortuosity than the control group (P<0.0001 for all). Foveal width was significantly greater in the patient group (1592.39±175.56 µm) compared with the control group (1391.01±175.56 µm) (P<0.0001), whereas foveal depth was significantly lower in the patient group (121.15±26.83 µm) than in the control group (146.1±12.25 µm) (P<0.0001). The mean total retinal thickness was 253.53±22.31 µm in the patient group and 261.03±18.48 µm in the control group (P=0.007). Similarly, central retinal thickness was significantly lower in the patient group (219.35±10.53 µm) compared with the control group (235.32±12.51 µm) (P<0.0001). DISCUSSION: Our study shows that pediatric patients with SCD may have subclinical retinal involvement and that temporal thinning, in particular, is an important OCT finding. This strongly suggests that OCT imaging would be a beneficial addition to routine ophthalmologic examination in the diagnosis and follow-up of this patient group.

Assessment of clitoral anatomy in human fetuses.

PURPOSE: To determine fetal clitoral dimensions in antenatal period and to provide a contribution to external genital morphology determination in premature infants. METHODS: Thirty-one formalin fixed female fetuses aged between 18 and 40 weeks (17 fetuses aged 21.53 ± 1.88 weeks in the second trimester and 14 fetuses aged 31.00 ± 4.90 weeks in the third trimester) were evaluated. 20 (64.5%) fetuses were between 3 and 97% percentile range and within normal limits. Clitoris appearance (completely covered by labium majus/partially showing/prominent), length and width of clitoris, labium minus length, length, and width of labium majus were assessed. RESULTS: Clitoris length during the second trimester was 4.84 ± 1.09 mm, whereas it was 5.43 ± 1.07 in the third trimester. Clitoris width was as 3.35 ± 0.88 mm in the second trimester and as 4.55 ± 0.96 mm in the third trimester. A statistically significant increase was seen in width of clitoris, length, and width of labium majus and length of labium minus with gestational age in the second and third trimesters (p < 0.05). No significant difference was found between the second and third trimesters in terms of clitoris length (p = 0.146). A homogenous spread in clitoris appearance was obtained between the second and third trimesters without any significant difference (p = 0.912). In addition, fetus percentiles showed a homogenous spread without any significant differences between completely covered, partially covered and prominent groups (p = 0.452). CONCLUSION: The anatomical data can be beneficial to the development of fetal radiological screening procedures in females and also in morphological assessment criteria in premature infants, effectively assisting in diagnosing anomalies during the early term.

Radiologic analysis of the location, shape and size of the external aperture of the carotid canal in children.

OBJECTIVES: This retrospective computed tomography (CT) study was aimed to assess the growth dynamic of the external aperture of the carotid canal (EACC) in children aged between 1 and 20 years. METHODS: Two hundred patients (sex 100 females/100 males, average age 10.50 ± 5.77 years) with good head CT image quality were included in this study. CT images of the patients were used to obtain data related to the location, shape and dimension of EACC. RESULTS: EACC shapes were identified as oval shaped, round shaped, and tear-drop shaped in 58.3% (233 sides), 24% (96 sides) and 17.8% (71 sides), respectively. EACC length, disEACC-MSP (distance between EACC and midsagittal plane), and EACC width did not change from the prepubescence period; while, the disEACC-SC (distance between EACC and supramastoid crest) seemed to reach adult size in the postpubescence period. Linear functions for EACC length and width were calculated as: y = 5.453 + 0.091 × years, and y = 5.398 + 0.059 × years, respectively. CONCLUSION: The regression equations of the measured parameters representing the growth dynamic of EACC in children can be helpful to estimate its size, location and angulation, which suggest that the dimension and distances to certain anatomical landmarks seemed to reach adult size in different developmental periods. In this context, the findings of this study may seem to emphasize the importance of preoperative radiological evaluation on skull base, related to EACC, for multidisciplinary surgeon teams during childhood surgeries in terms of patients' positioning, and the selection of appropriate surgical approach.

[Investigation of the Relationship Between TNF-α, IL-12A, IL-12B and IFN-γ Gene Polymorphisms and Chronic Hepatitis C]. / TNF-α, IL-12A, IL-12B ve IFN-γ Gen Polimorfizmleri ile Kronik Hepatit C Arasindaki Iliskinin Arastirilmasi.

Hepatitis C virus (HCV) infection is still an important public health problem worldwide. Cytokines play an important role in the prognosis of HCV infections. Polymorphisms in the cytokine genes can affect the gene expression and change the clinical course of the disease. The aim of this study was to determine the relationship between chronic hepatitis C and TNF-α rs1799964 (-1031 T/C), IL-12A rs568408 (3'UTR G/A), IL-12B rs3212227 (3'UTR A/C) and IFN-γ rs2430561 (+874 A/T) gene polymorphisms. A hundred patients with chronic hepatitis C and 100 healthy people as control group were included in the study. Approximately 2 ml peripheral blood was taken from the patient and control groups into tubes with EDTA and genomic DNA was obtained using the DNA isolation kit. Single nucleotide polymorphisms in TNF-α (rs1799964), IL-12A (rs568408), IL-12B (rs3212227) and IFN-γ (rs2430561) genes were investigated by using the real-time polymerase chain reaction (Rt-PCR) method. The data obtained were analyzed in SPSS package program. There was no statistically significant relationship between chronic hepatitis C and TNF-α and IFN-γ polymorphisms in terms of genotype and allele distributions (p> 0.05). However, it was found that the relationship between IL-12A (G/A) and IL-12B (A/C) polymorphisms was significant (p< 0.05). The frequencies of IL-12A GA (OR= 4.828, 95% CI= 1.452-16.046, p= 0.010) and AA genotypes (OR= 4.436, 95% CI= 1.398-14.077, p= 0.011) and A alele (OR= 1.602, 95% CI= 1.020-2.518, p= 0.040) were found to be higher in the patient group. When the relationship between chronic hepatitis C and IL-12B gene polymorphism was examined, it was determined that the frequencies of AC (OR= 2.060, 95% CI= 0.836-5.076, p= 0.116) and CC (OR= 3.020, 95% CI= 1.242-7.345, p= 0.015) genotypes and C allele (OR= 1.750, 95% CI= 1.152-2.659, p= 0.008) were high in the patient group. In addition, TNF-α TC/CC, IL-12A GA/AA, IL-12B AC/CC and IFN-γ TT genotypes were found to be 7.5 times higher in the patient group than the control group (OR= 7.500, 95% CI= 1.532-36.714, p= 0.013). Our results showed that IL-12A (3'UTR G/A) and IL-12B (3'UTR A/C) gene polymorphisms and TNF-α TC/CC, IL-12A GA/AA, IL-12B AC/CC and IFN-γ TT interactions may be effective in the risk of the chronicity of hepatitis C. However, further studies are needed to determine the role of polymorphisms in these cytokine genes in HCV infections.

Radiologic Evaluation of Exiting Points of Supraorbital Region Neurovascular Bundles in Patients With Migraine.

PURPOSE: To reveal the presence and nature of exiting points of supraorbital region neurovascular structures and determine the distances of those structures to midline with computed tomography images by taking into account gender and sides in patients with migraine. METHODS: The study was conducted retrospectively on computed tomography images of 70 migraine and 70 control patients with a mean age of 39.5 ±â€Š13.8 years (range: 18-80). Presence and nature (foramen or notch) of exiting points of neurovascular structures in terms of side and gender in both groups, and the distances of these structures to the midline of the face were evaluated. RESULTS: In migraine and control groups, the most commonly seen structure was single notch. Coexistence of foramen and notch was statistically significant in migraine and female migraine groups than control and female control groups (P < 0.05). Bilateral presence of supraorbital structure was 51.4% in migraine group and 64.3% in control group patients. In all cases, foramen-midline distance was statistically significant longer than the notch-midline distance (P < 0.05). In migraine patients, no statistically significant difference was detected regarding distances of foramen and notch to midline in terms of side and gender. CONCLUSION: Consideration of variable presence and location of the supraorbital notch and foramen, analysis of computed tomography scan might be beneficial in preoperative planning of foraminotomy and fascial band release in adult migraine patients to prevent intraoperative complications. Also, coexistence is more frequent on left side in migraine patients that might cause overlooking those structures during surgery.

Intravitreal bevacizumab effects on VEGF levels in distant organs: an experimental study.

PURPOSE: The aim of this study was to determine the effects of single-dose intravitreal bevacizumab on the levels of vascular endothelial growth factor (VEGF) in serum and distant organs. METHODS: Adult New Zealand albino rabbits (n = 40) were divided into experimental and control groups. Experimental rabbits received a single 0.05 ml intravitreal injection of 1.25 mg bevacizumab (Avastin) into the right eye, and control rabbits (n = 8) received no injection. Following injection, group 1 rabbits (n = 8) were sacrificed on day 1, group 2 rabbits (n = 8) on day 7, group 3 rabbits (n = 8) on day 14, and group 4 rabbits (n = 8) on day 28; control rabbits were sacrificed on day 28. After sacrifice, samples of brain, heart, liver, kidney and blood were collected. Levels of VEGF in serum and tissue were measured using enzyme-linked immunosorbent assay. The presence of bevacizumab was evaluated by immunofluorescence staining in tissues. RESULTS: Positive bevacizumab immunoreactivity was observed in brain, heart and kidney. Serum VEGF levels significantly decreased in groups 3 and 4 compared with controls (p < 0.05). Liver VEGF levels significantly decreased in group 3 compared with controls (p < 0.05). CONCLUSIONS: Intravitreal bevacizumab not only may escape from the blood-retinal barrier and enter the general circulation, but also may be disseminated to distant organs. Our study demonstrates that a single dose of intravitreally injected bevacizumab decreases VEGF levels in serum and liver.

Patterns of Child and Adolescent Psychiatric Admissions Before and After the Onset of the COVID-19 Pandemic: Take Home Messages from a Clinical Population.

Background: : This study from Istanbul aimed to compare the child and adolescent psychiatric admissions and diagnosis rates between the first 3 months of the pandemic, the previous 3 months in the same year, and the same months in the previous year. Methods: : Children and adolescents were grouped according to the admission dates. Group A, between March 11 and June 1, 2020; Group B, between January 1 and March 11, 2020; and Group C, between March 11 and June 1, 2019. Only clinical interviews and diagnoses according to Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) interview were included. Results: : Autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD)/tic disorder, and intellectual disability (ID) diagnoses were higher in group A than in groups B and C (for ASD, 6.4%, 4.3%, and 3.6%; for OCD/tic disorder, 2.9%, 1.8%, 1.7%; for ID, 3.7%, 2.5%, and 2.1%, respectively) (P < .001). Attention-deficit hyperactivity disorder (ADHD) diagnosis was higher in group A than in only group B (59.8% and 49.7%, respectively) (P < 0.001). Depression was higher in group A than in only group C (4.1% and 2.2%, respectively) (P < .001). Conduct disorder (CD) diagnosis was lower in group A than in only group B (3.6% and 6.4%, respectively) (P < .05). Conclusion: : Child psychiatry diagnosis rates were found to change significantly during the initial phase of the pandemic period. Among the referrals, ASD, OCD, Tic disorder, ID, ADHD, and depression admissions were significantly higher. The rate of pediatric neurodevelopmental disorders, particularly ASD, increased during the initial phase of the COVID-19 pandemic.

Maternal separation increased memory function and anxiety without effects of environmental enrichment in male rats.

Maternal separation is a detrimental postnatal influence, whereas environmental enrichment is a therapeutic and protective agent. It is unclear if long-term environmental enrichment can compensate for the effects of maternal separation stress on memory-related alterations. This study examined how environmental enrichment affected memory functions, anxiety level, Grin2a, Grin2b, BDNF, and cFos expressions in the maternally separated rats. There are seven groups in this study: control (C), maternal separation+standard cage (MS), maternal separation + enriched cage (MSE), enriched cage (E), the maternal separation that decapitated at postnatal 21 (MS21) and standard cage that decapitated at PN21 (C21) for hormone and gene expression analysis. The maternal separation procedure consisted of postnatal 21 days. Learning and memory performance were determined with the Morris water tank test; anxiety and locomotor activity were examined with the open field and elevated plus-maze test. The expression levels of genes were measured by the RT-PCR method. Blood corticosterone level was evaluated by the ELISA method. Results showed that MS increased memory performance, locomotor activity, and anxiety, but it did not change gene expression levels. An enriched environment did not change the memory performance, locomotor activity, and related gene expression levels. MSE group increased their memory performance, but the anxiety, locomotor activity, and gene expression level did not change. Grin2a, Grin2b, and BDNF gene expression and corticosterone levels increased in the MS21 group. Maternal separation increased memory performance, but it also increased anxiety. Environmental enrichment alone was insufficient to cause alterations in the memory performance.

A Morphometric Evaluation Together with Computed Tomography Examination of Chiari Type 1 Cases with Craniovertebral Junction Anomaly.

AIM: To compare the posterior cranial fossa (PCF) dimensions together with the measurements related to basilar invagination and platybasia of craniovertebral junction anomalies (CVJA) in CVJA (+) and CVJA (-) Chiari malformation Type 1 (CM1) patient groups with each other and with healthy control subjects. MATERIAL AND METHODS: The study group was formed of 43 CM1 and 9 tonsillar ectopia (TE) patients. RESULTS: A decrease was determined in the PCF vertical length (clivus and supraocciput line) and PCF volume and an increase in the transverse length (McRae and Twining line) in the CM1 cases compared to the healthy control group. There was no difference between the CVJA (+) and (-) CM1 groups in respect of the vertical and transverse length and PCF volume values. An increase in the classic and modified skull base angles was observed in the CVJA (+) CM1 group compared to the CVJA (-) CM1 group. The Wackenheim clivus angle was determined to be smaller in the CVJA (+) CM1 group compared to the CVJA (-) CM1 group. CONCLUSION: The PCF is flattened and smaller in CM1 cases compared to normal control subjects. In the planning of CM1 operations, the angle parameters may be more useful than the PCF and CVJA length parameters between CVJA (+) and (-) CM1 groups. The significant decrease in postoperative recovery in the CVJA (+) CM1 group compared to the CVJA (-) CM1 group supports the need for additional operations and/or a different surgical technique in the treatment of CVJA (+) CM1 patients.

Hyperthyroidism leads learning and memory impairment possibly via GRIN2B expression alterations.

The hippocampus as an important structure for learning and memory functions contains a high level of thyroid hormone receptors. Although there are numerous studies investigating the effects of thyroid hormones on cognitive dysfunction and psychiatric symptoms, the underlying molecular processes of these disorders have not yet been fully elucidated. In the present study, 24 male adult rats (4 months) were divided into 3 groups: control group, sham group and hyperthyroid group. Hyperthyroid group and sham group were treated with l-thyroxine or saline for 21 days. Each group was exposed to Morris water maze testing (MWMT), measuring their performance in a hidden-platform spatial task. After learning and memory tests, intracardiac blood was taken from the rats for serum thyroxine levels. Following blood collection, the rats were decapitated to isolate hippocampal tissue. GRIN2A, GRIN2B, BDNF, cFOS, Cdk5, cdk5r1 (p35), and cdk5r2 (p39) gene expression were evaluated using quantitative reverse transcriptase-PCR. Serum thyroxine level was found to be higher in hyperthyroid rats than in the control and sham groups. According to our MWMT findings, the memory performance of the hyperthyroid group was significantly impaired compared to the control and sham groups (p < 0.05). In the hippocampus, the GRIN2A gene expression level was decreased in the sham group, and the GRIN2B gene expression level was decreased in the sham and hyperthyroid groups compared to the control group (p < 0.05). There was no significant difference in other genes (p > 0.05). Hyperthyroidism impaired hippocampus-dependent spatial memory. Hyperthyroidism caused decreased level of GRIN2B gene expression in the hippocampus.

Evaluation of Plasma miR-17-5p, miR-24-3p and miRNA-223-3p Profile of Hepatitis C Virus-Infected Patients after Treatment with Direct-Acting Antivirals.

The expression of miR-223-3p, miR-17-5p, and miR-24-3p was evaluated in hepatitis C virus (HCV) patient serum samples, collected before DAA treatment and after a sustained virological response (SVR). Fifty HCV patients were stratified based on their liver damage stages into three different subgroups (21 with chronic hepatitis-CH, 15 with cirrhosis, and 14 with hepatocellular carcinoma-HCC). Considering the entire HCV population, the miRNA expression levels were significantly downregulated after the SVR compared to pre-treatment ones (p < 0.05). Stratifying the patients based on liver damage, the post-SVR values of the three miRNAs were significantly downregulated compared to the pre-treatment levels for both cirrhosis and HCC patients. No significant differences emerged from the analysis of the CH group. To our knowledge, this is the first study to detail the behavior of miR-223-3p, miR-17-5p, and miR-24-3p levels in patients with HCV-related CH, cirrhosis, and HCC after DAA therapy. Our findings show that HCV-infected patients have different miRNA profiles before and after treatment with DAAs, strongly suggesting that miRNAs may be involved in the pathogenesis of HCV-related damage. In this respect, the correlation observed among the three studied miRNAs could imply that they share common pathways by which they contribute the progression of HCV-induced chronic liver damage.