Role of Glutamate Receptor-related Biomarkers in the Etiopathogenesis of ADHD

Objective@#Pathways associated with glutamate receptors are known to play a role in the pathophysiology of attention-deficit hyperactivity disorder (ADHD). However, cyclin-dependent kinase 5 (CDK5), microtubule-associated protein-2 (MAP2), guanylate kinase-associated protein (GKAP), and postsynaptic density 95 (PSD95), all of which are biomarkers involved in neurodevelopmental processes closely related to glutamatergic pathways, have not previously been studied in patients with ADHD. The main purpose of this study was to evaluate the plasma levels of CDK5, MAP2, GKAP, and PSD95 in children with ADHD and investigate whether these markers have a role in the etiology of ADHD. @*Methods@#Ninety-six children with ADHD between 6 and 15 years of age and 72 healthy controls were included in the study. Five milliliters of blood samples were taken from all participants. The samples were stored at −80°C until analyzed by the enzyme-linked immunosorbent assay method. @*Results@#Statistically significantly lower CDK5 levels were observed in children with ADHD than in healthy controls (p = 0.037). The MAP2, GKAP, and PSD95 levels were found to be statistically significantly higher in the ADHD group than in healthy controls (p = 0.012, p = 0.009, and p = 0.024, respectively). According to binary regression analysis, CDK5 and MAP2 levels were found to be predictors of ADHD. @*Conclusion@#In conclusion, we found that a close relationship existed between ADHD and glutamatergic pathways, and low levels of CDK5 and high levels of MAP2 and GKAP played a role in the etiopathogenesis of ADHD.

Physical activity, anxiety, depression, and coping in Turkish men and women during the first wave of COVID-19 / Atividade física, ansiedade, depressão e enfrentamento em homens e mulheres turcos durante a primeira onda de COVID-19 / Actividad física, ansiedad, depresión y afrontamiento en hombres y mujeres turcos durante la primera ola de COVID-19

Abstract: A need exists to better understand the relationships between COVID-19, coping behaviors, physical activity and stress, and COVID-19's impact on way of life. A cross-sectional study design was used to examine adult physical activity, hope, depression, anxiety, and coping status by gender during the COVID-19 pandemic, and to determine the impact of these variables on the coping process. The study also examined the effect of gender on the relation between physical activity and dependent variables. A global survey instrument was used in this study, including 1,400 Turkish adults. This study identified significant gender-based differences regarding physical activity, hope, depression, anxiety, and coping status of adults, although no significant gender-based difference was found regarding hope scores. Furthermore, physical activity directly influenced coping (β = 0.10), hope (β = 0.12), and anxiety (β = -0.08). Hope directly and positively influenced coping (β = 0.45) and directly and negatively influenced anxiety (β = -0.25) and depression (β = -0.28). Moreover, gender did not directly affect physical activity, but it was associated with decreased coping and increased depression and anxiety. Finally, gender had no effect on the relation between physical activity and hope, coping, depression, and anxiety (p > 0.01). These outcomes support the critical importance of physical activity and hope when coping with COVID-19 regardless of gender.

Resumo: Existe uma necessidade de entender melhor as relações entre a COVID-19, comportamentos de enfrentamento, atividade física e estresse e o impacto da COVID-19 no modo de vida. Um desenho de estudo transversal foi usado para examinar a atividade física adulta, esperança, depressão, ansiedade e estado de enfrentamento por gênero durante a COVID-19 e para determinar os efeitos de atividade física, esperança, depressão, e ansiedade no enfrentamento da COVID-19. Finalmente, examinou-se o efeito do gênero na relação entre atividade física e variáveis dependentes. Um instrumento de pesquisa global foi utilizado neste estudo, no qual um total de 1.400 adultos turcos participaram. Os resultados desta investigação demonstram que existem diferenças significativas em atividade física, esperança, depressão, ansiedade e estado de enfrentamento de adultos por sexo. Não houve diferença significativa entre os sexos para os escores de esperança. Além disso, a atividade física influenciou diretamente o enfrentamento (β = 0,10), a esperança (β = 0,12) e a ansiedade (β = -0,08). A esperança influenciou direta e positivamente o enfrentamento (β = 0,45) e influenciou direta e negativamente a ansiedade (β = -0,25) e a depressão (β = -0,28). Além disso, o gênero não afetou diretamente a atividade física, mas o gênero foi associado à diminuição do enfrentamento e ao aumento da depressão e ansiedade. Finalmente, o gênero não teve efeito sobre a relação entre atividade física e esperança, enfrentamento, depressão, ansiedade (p > 0,01). Estes resultados apoiam a importância crítica da atividade física e da esperança ao lidar com COVID-19 sem efeitos de gênero.

Resumen: Existe la necesidad de comprender mejor las relaciones entre COVID-19, los comportamientos de afrontamiento, la actividad física y el estrés, y el impacto de COVID-19 en la forma de vida. Se utilizó un diseño de estudio transversal para examinar la actividad física del adulto, la esperanza, la depresión, la ansiedad y el estado de afrontamiento por género durante COVID-19 y para determinar los efectos de la actividad física, la esperanza, la depresión, y ansiedad en el afrontamiento de COVID-19. Finalmente, se examinó el efecto del género en la relación entre la actividad física y las variables dependientes. En este estudio se utilizó un instrumento de investigación global, en el que participaron un total de 1.400 adultos turcos. Los resultados de esta investigación demuestran que existen diferencias significativas en la actividad física, la esperanza, la depresión, la ansiedad y el estado de afrontamiento de los adultos por sexo. No hubo diferencias significativas entre los sexos para las puntuaciones de esperanza. Además, la actividad física influyó directamente en el afrontamiento (β = 0,10), la esperanza (β = 0,12) y la ansiedad (β = -0,08). La esperanza influyó directa y positivamente en el afrontamiento (β = 0,45) e influyó directa y negativamente en la ansiedad (β = -0,25) y la depresión (β = -0,28). Además, el género no afectó directamente a la actividad física, pero el género se asoció con una disminución del afrontamiento y a un aumento de la depresión y la ansiedad. Finalmente, el género no tuvo ningún efecto sobre la relación entre la actividad física y la esperanza, el afrontamiento, la depresión, la ansiedad (p > 0,01). Estos resultados respaldan la importancia crítica de la actividad física y la esperanza cuando se trata de COVID-19 sin efectos de género.

Validity and reliability of Turkish pregnant women's preferences for mode of delivery questionnaire

SUMMARY OBJECTIVE: The aim of this study was to determine whether Pregnant Women's Preferences for Mode of Delivery Questionnaire, created by Zamani-Alavijeh et al., is a valid and reliable measurement tool for Turkish pregnant women. METHODS: This study has a methodological research design and was conducted with 139 pregnant women who were randomly selected from those aged 18-35 years, who applied to obstetric clinic,.who had no previous prenatal losses and no systemic diseases, and who had conceived naturally. The data for this study were collected with the Personal Information Form and the Pregnant Women's Preferences for Mode of Delivery Questionnaire. To test the reliability and validity of Pregnant Women's Preferences for Mode of Delivery Questionnaire, Cronbach's α, split-half method, item analysis, Kendall's coefficient of agreement (W), explanatory factor analysis, and confirmatory factor were used. RESULTS: The study found that Cronbach's α was 0.94, the Spearman-Brown reliability coefficient was 0.883, and the Guttman split-half was 0.880. Explanatory factor analysis revealed an 18-item structure with three factors having an eigenvalue exceeding 1, explaining 67.593% of the total variability, and factor loading between 0.40 and 0.64. CONCLUSION: Based on the scientific recommendations, the Turkish version of the Pregnant Women's Preferences for Mode of Delivery Questionnaire has adequate psychometric properties.

Comparison of treatment efficacy of omega-3 fish oil and montelukast in ovalbumin-protease-induced allergic rhinitis model in rats

Abstract Objectives Montelukast is a well-known leukotriene receptor antagonist commonly used in treating allergic rhinitis and asthma. Omega-3 fatty acid is also known as an antiallergic and immunomodulator molecule. This study aimed to elucidate the efficacy of systemic montelukast and omega-3 fatty acid treatment in allergic rhinitis models in Wistar Hannover rats. Methods This research was conducted on 28 healthy Wistar Hannover rats weighing 250-350 g. After establishing the allergic rhinitis model, nasal symptoms were observed and scored, and the nasal mucosa of all rats was investigated histologically. Light microscopy was utilized to evaluate the degree of ciliary loss, goblet cell hyperplasia, vascular congestion, vascular proliferation, inflammatory cell infiltration, eosinophil infiltration, and hypertrophy in chondrocytes. Results As a result of the analysis of the data obtained from the study, it was determined that typical allergic rhinitis symptoms such as nasal scratching and sneezing were significantly reduced in the rats in the montelukast and omega-3 treated group, and these symptoms did not increase after repeated intranasal OVA-protease applications. Histological examinations after fish oil treatment did not reveal typical inflammatory changes in allergic rhinitis. None of the rats in the montelukast and omega-3 groups had any increase in goblet cells, whereas 14.3% of the rats in the control group and 28.6% of the rats in the allergic rhinitis group had mild increase. Last but not least, 71.4% of rats in the allergic rhinitis group had a moderate increase. The difference between the groups was statistically significant (p< 0.001). Conclusion Regarding the outcomes of this research, it was observed that w-3 fatty acids had antiallergic effects, both histopathological and clinical, in the allergic rhinitis model. We believe that further randomized controlled trials incorporating larger cohorts are warranted to verify the use of omega-3 fatty acids in treating allergic rhinitis. The level of evidence of this article is Level 2.

Dental students' empathy levels and opinions about attributes for "good dentist": a cohort study

Empathy is fundamental to the physician-patient relationship and influences the clinical outcomes. The aim of this study was to determine the dental students' empathy levels and to compare their opinions on attributes of a "good dentist". This cohort research was included 79 dental students volunteering to participate in the study at a public university. The data were collected by the Dökmen's Empathic Tendency Scale (ETS) and Empathic Skill Scale (ESS). In this study, from the orientation day to the end of the third-year, the dental students' ETS mean scores (respectively 69.59 and 68.34) and ESS mean scores (respectively 142.53 and 140.00) showed a decline. At the end of the third-year, starting clinical rotations and taking patient responsibility may lead to decrease the empathy levels of students. The findings of our study show that female students have higher empathy tendency and skill scores compared to male students (p<0.001). In the ranking of the attributes required to be a good dentist, empathy was ranked 4th by the first-year students, while final-years students placed empathy in second rank (p<0.05). According to these results, it is possible to claim that the dentist candidates realized that being empathetic is necessary to be a good dentist.

La empatía es fundamental para la relación médico-paciente e influye en los resultados clínicos. El objetivo de este estudio de cohorte -que incluyó a 79 estudiantes de odontología de una universidad pública que se ofrecieron como voluntarios- fue determinar los niveles de empatía de los estudiantes de odontología y comparar sus opiniones sobre los atributos de un "buen dentista". Los datos se recogieron mediante las Escalas de Tendencia Empática (ETE) y Habilidad Empática (EHE) de Dökmen. Desde el día de orientación hasta el final del tercer año, los puntajes medios ETE de los estudiantes de odontología (69.59 y 68.34, respectivamente) y los puntajes medios de EHE (142.53 y 140.00, respectivamente) mostraron una disminución. Según la literatura, al final del tercer grado, iniciar rotaciones clínicas y asumir la responsabilidad del paciente puede llevar a disminuir los niveles de empatía de los estudiantes. Los hallazgos de nuestro estudio muestran que las estudiantes tienen una mayor tendencia a la empatía y puntajes de habilidad en comparación con los estudiantes (p<0.001). En el ranking de los atributos requeridos para ser un buen dentista, la empatía ocupó el cuarto puesto en estudiantes de primer año, mientras que los de último año colocaron la empatía en segundo lugar (p<0.05). De acuerdo con estos resultados, es posible afirmar que los candidatos a dentistas se dieron cuenta de que ser empáticos es necesario para ser un buen dentista.

A empatia é fundamental na relação médico-paciente e influencia os resultados clínicos. O objetivo deste estudo foi determinar os níveis de empatia de estudantes de odontologia e comparar suas opiniões sobre os atributos de um "bom dentista". Esta pesquisa de coorte contou com 79 estudantes de odontologia voluntários para participar do estudo em uma universidade pública. Os dados foram coletados pela Escala de Tendência Empática (ETE) de Dökmen e Escala de Habilidades Empáticas (EHE). Neste estudo, desde o dia da orientação até o final do terceiro ano, os escores médios do ETE dos alunos de odontologia (respectivamente 69,59 e 68,34) e os escores médios do EHE (respectivamente 142,53 e 140,00) apresentaram declínio. No final da terceira série, iniciar os rodízios clínicos e assumir a responsabilidade do paciente pode levar à diminuição dos níveis de empatia dos alunos. Os achados do nosso estudo mostram que os alunos do sexo feminino apresentam maior tendência à empatia e pontuações de habilidades em comparação aos alunos do sexo masculino (p<0,001). No ranking dos atributos necessários para ser um bom dentista, a empatia foi classificada em 4º lugar pelos alunos do primeiro ano, enquanto os alunos do último año colocaram a empatia em segundo lugar (p<0,05). De acordo com esses resultados, é possível afirmar que os candidatos a dentista perceberam que ser empático é necessário para ser um bom dentista.

Monocyte to High-Density Lipoprotein Cholesterol Ratio Decreased in Patients with Psoriasis Treated with Ixekizumab

ABSTRACT Background: Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a novel inflammatory biomarker which has been associated with cardiovascular diseases. Objective: To study MHR in patients with psoriasis treated with biological agents. Methods: Between April 2019 and August 2022, MHR was retrospectively evaluated in patients with psoriasis before and 3 months after treatment with infliximab, adalimumab, etanercept, ixekizumab, secukinumab, and ustekinumab in a university hospital in Ankara, Turkey. Results: This study included 128 patients, 53 females and 75 males. 39 (30.5%) patients were treated with infliximab, 26 (20.3%) with adalimumab, 8 (6.3%) with etanercept, 18 (14.1%) with ixekizumab, 12 (9.4%) with secukinumab, and 25 (19.5%) with ustekinumab. The median MHR was 0.0127 (0.0086-0.0165) in females and 0.0146 (0.0119-0.0200) in males (p = 0.011). The median MHR decreased after treatment with adalimumab, ixekizumab, secukinumab, and ustekinumab, whereas it increased after treatment with infliximab and etanercept (p = 0.790, p = 0.015, p = 0.754, p = 0.221, p = 0.276, p = 0.889, respectively). Conclusion: MHR significantly decreased in patients with psoriasis after treatment with ixekizumab. Since high MHR levels have been associated with poor clinical outcomes in patients with cardiovascular diseases, ixekizumab might have a positive impact in the treatment of psoriasis patients who had cardiovascular diseases. We suggest that MHR may be useful both in establishing appropriate biological agent treatment and in the follow-up of patients with psoriasis treated with biological agents.

Determination of the Depression, Anxiety and Stress Levels of Hairdressers during the COVID-19 Pandemic and the Associated Factors

Background: COVID-19 affected negatively almost every person in the world. This process has brought psychological disorders, social and economic problems at the societies especially in business sector. So this study was conducted to determine the factors related with depression, anxiety and stress levels of hairdressers during COVID-19 pandemic. Material and methods: This analytic research was conducted with 103 volunteer hairdressers who were reached by snowball sample. The data were collected with a personal data form and the DASS- 21 Scale. Results: Of the participants, 40.8% were in the 14-30 years age group, 57.3% were female, 58.3% were high school graduates. Of them, 68% were affected negatively due to the COVID-19. The COVID-19 had negative effects on the mental health status of hairdressers. The mental health of hairdressers was affected by gender, income status, chronic disease status, psychotherapy status, negative impact of COVID-19 process, daily working time and daily sleep duration significantly affect the mental health of hairdressers. Conclusion: The supporting mental health services and the adjustments can be given to small business owners, especially to hairdressers. In addition, further studies that determine of the effects of the COVID-19 on the economic and mental health of the small business owners can be useful.

PD-L1 and PD-L2 expression in colorectal cancer

Context: The programmed death-1 (PD-1) is an immune checkpoint molecule that suppresses T-cell response. The binding of PD-1 to PD-L1/PD-L2 results cytokine production, and T-cell proliferation are reduced. Tumors expressing PD-L1 and PD-L2 escape from cytotoxic T-cells and are exposed to tumor progression. For this reason, immunotherapy has become a new option in the treatment of cancer. Aims: In this study, we examined the PD-L1 and PD-L2 expression in colorectal carcinoma (CRC), and evaluated the relationship between clinicopathological parameters and CD8+ T cells. Methods and Material: We evaluated CD8 expression in tumor-infiltrating lymphocytes and surrounding tumor lymphocytes with PD-L1, PD-L2 staining in tumor cells and immune cells formalin-fixed paraffin embedded samples of 124 patient diagnosed with CRC. Statistical Analysis Used: Pearson Chi-Square, Fisher Exact Chi-Square, and Pearson Exact Chi-Square analyses were used in the analysis of the cross tables. Survival distributions predicted Kaplan--Meier method and it was evaluated using log-rank statistics. Results: In our study, a significant correlation was found between PD-L1 expression and female sex and tumors with medullary morphology. No expression of PD-L2 was observed in tumors containing medullary morphology, and a statistically inverse relationship was observed between PD-L2 and the medullary component. PD-L1 positive tumor-infiltrating lymphocytes were determined to be an important predictor for recurrence-free survival. Conclusions: We believe that the evaluation of these parameters may be useful in the selection of patients who will benefit from immunotherapy in CRC cases.

Nivolumab rechallenge after severe immune hepatitis in a metastatic renal cell cancer patient with hepatitis B and no detectable primary

Renal cell carcinoma (RCC) is an aggressive tumor with high metastatic potential and most of cases are determined incidentally on radiologic imaging. Metastatic RCC (mRCC) without a primary is very rare, and only a small number of cases have been reported in the literature. In recent years, immune checkpoint inhibitors have been used to treat mRCC, but they are associated with immune-related adverse events. Immune hepatitis is rare and usually observed within three months of initiation of therapy. Patients with hepatitis B virus (HBV) infection have generally been excluded from immunotherapy trials, although a small number of reports and retrospective studies exist on the use of immunotherapy in patients with HBV infection. A 59-year-old man was diagnosed with mRCC with adrenal and liver metastases and vena cava inferior thrombosis but without evidence of a primary. Second-line therapy with nivolumab achieved a good clinical response, but grade IV immune-related hepatitis was observed after one year. He also had an occult HBV infection. However, HBV reactivation did not occur with continuous entecavir prophylaxis. The hepatitis gradually resolved within two months without any management, and the patient was rechallenged with nivolumab. Metastatic RCC rarely presents without a primary mass in the kidney. In such cases, histologic and immunohistochemical characteristics are critical. Nivolumab-induced immune hepatitis may occur as late as one year after initiation of therapy. Rechallenge of immunotherapy may be considered in selected patients. HBV infection is not a contraindication for immunotherapy, these patients can be treated safely with frequent monitoring and antiviral prophylaxis

Does cryptogenic organizing pneumonia change seasonal?

SUMMARY BACKGROUND AND AIM: Meteorological factors affect the respiratory system, and the most important factor is the change in ambient temperature and humidity. We aimed to investigate the seasonal characteristics of patients diagnosed with cryptogenic organizing pneumonia. METHODS: The study included 84 cryptogenic organizing pneumonia, 55 chronic obstructive pulmonary disease, and 42 asthma patients. To determine the characteristics of the disease according to the seasons, the number of attacks and admissions was grouped according to the seasonal characteristics and analyzed for three groups. RESULTS: Among cryptogenic organizing pneumonia and chronic obstructive pulmonary disease patients, males significantly predominated (p<0.001). The hospitalization rate was highest in chronic obstructive pulmonary disease patients but similar to cryptogenic organizing pneumonia and asthma patients (p<0.001). The highest admission rate in cryptogenic organizing pneumonia patients was observed in spring (39.3% in spring, 26.2% in fall, 22.6% in winter, and 11.9% in summer). In winter, cryptogenic organizing pneumonia patients were admitted less frequently than chronic obstructive pulmonary disease and asthma patients. The neutrophil-to-lymphocyte ratio was higher in cryptogenic organizing pneumonia patients than in asthma patients and similar to chronic obstructive pulmonary disease patients. CONCLUSION: As a result of our study, the high rate of diagnosis and admission in the spring in cryptogenic organizing pneumonia suggested that the effect of allergens on the formation of cryptogenic organizing pneumonia should be investigated. In contrast, it should be kept in mind that cryptogenic organizing pneumonia may develop as a prolonged finding of involvement that may occur in the lung parenchyma due to lung infections and/or cold weather triggering during the winter months. In this regard, further studies can be conducted in which allergens and/or the history of infection in patients and meteorological variables are also evaluated.

A novel differential diagnosis algorithm for chronic lymphocytic leukemia using immunophenotyping with flow cytometry

Abstract Introduction The availability of a clinical decision algorithm for diagnosis of chronic lymphocytic leukemia (CLL) may greatly contribute to the diagnosis of CLL, particularly in cases with ambiguous immunophenotypes. Herein we propose a novel differential diagnosis algorithm for the CLL diagnosis using immunophenotyping with flow cytometry. Methods The hierarchical logistic regression model (Backward LR) was used to build a predictive algorithm for the diagnosis of CLL, differentiated from other lymphoproliferative disorders (LPDs). Results A total of 302 patients, of whom 220 (72.8%) had CLL and 82 (27.2%), B-cell lymphoproliferative disorders other than CLL, were included in the study. The Backward LR model comprised the variables CD5, CD43, CD81, ROR1, CD23, CD79b, FMC7, sIg and CD200 in the model development process. The weak expression of CD81 and increased intensity of expression in markers CD5, CD23 and CD200 increased the probability of CLL diagnosis, (p < 0.05). The odd ratio for CD5, C23, CD200 and CD81 was 1.088 (1.050 - 1.126), 1.044 (1.012 - 1.077), 1.039 (1.007 - 1.072) and 0.946 (0.921 - 0.970) [95% C.I.], respectively. Our model provided a novel diagnostic algorithm with 95.27% of sensitivity and 91.46% of specificity. The model prediction for 97.3% (214) of 220 patients diagnosed with CLL, was CLL and for 91.5% (75) of 82 patients diagnosed with an LPD other than CLL, was others. The cases were correctly classified as CLL and others with a 95.7% correctness rate. Conclusions Our model highlighting 4 markers (CD81, CD5, CD23 and CD200) provided high sensitivity and specificity in the CLL diagnosis and in distinguishing of CLL among other LPDs.

Effect of pregnancy symptoms on the sexual quality of life

SUMMARY OBJECTIVE: This descriptive cross-sectional study aimed to determine the effect of pregnancy symptoms on the sexual quality of life. METHODS: This study included 150 pregnant women who visited the obstetrics and gynecology outpatient clinic of the hospital between October 1, 2019, and April 1, 2020, and met the inclusion criteria. Data were collected using the Personal and Obstetric Information form, Sexual Quality of Life-Female scale, and Pregnancy Symptom Inventory. RESULTS: The mean age of the participants was 27.7±5.2 years. As per the collected data, 39.3% of the participants had university- or higher-level education and 21.3% had an income-generating job. A weak negative correlation was found between the scores of Sexual Quality of Life-Female and frequency of pregnancy symptoms and limitation in daily activities (p=0.016 and p=0.020, respectively), whereas a strong positive correlation was found between frequency of pregnancy symptoms and limitation in daily activities. Regression analysis showed that as Sexual Quality of Life-Female scores decreased, frequency of pregnancy symptoms and limitation in daily activities scores increased (p<0.001). CONCLUSION: Our study showed that, as the frequency of symptoms experienced during pregnancy and their impact on daily life increase, the sexual quality of life decreases. We recommend providing education and counseling services to women and their partners about pregnancy symptoms and its impact on sexual life during pregnancy and implementing effective measures to eliminate the negative effects of these symptoms on the sexual quality of life.

Carpal Tunnel Syndrome in Patients with Psoriatic Arthritis:Ultrasonography and Magnetic Resonance Imaging Findings

Objective@#The aim of the present study is to assess carpal tunnel syndrome's (CTS’s) ultrasonography (US) and magnetic resonance imaging (MRI) findings in patients with psoriatic arthritis (PsA) and compare them with healthy controls. @*Methods@#Thirty-nine PsA and twenty-eight healthy volunteers were examined in this study. Demographic and clinical features were recorded. CTS-6, a diagnostic algorithm, was used to estimate the probability of CTS. Electrodiagnostic study (EDS) was applied to all wrists included in the report, where the diagnosis of CTS was made by EDS. The cross-sectional area (CSA) of the median nerve was measured at pisiform bone level by US and MRI. @*Results@#Regarding to the demographic characteristics, no statistically significant difference was found between the groups. Twelve of 39 (30.76%) PsA patients had CTS, whereas CTS was not detected in the control group (p=0.001). US and MRI showed increased median nerve CSA in PsA patients compared to healthy controls (p=0.005, p<0.001; respectively). Also, US and MRI showed increased median nerve CSA in CTS patients compared to others (p=0.002, p<0.001; respectively). The Pearson correlation coefficient between MRI and US measurements of the CSA was 0.85 (p<0.001). @*Conclusion@#CTS frequency in PsA patients is found higher than healthy controls. The relationship between CTS diagnosed by EDS and CSA measured by both US and MRI was observed in PsA patients.

Clinical assessment of various imaging systems for dental plaque scoring after the use of 3 different toothpastes

Purpose@#This study was conducted to compare dental plaque scores obtained through clinical examinations and various imaging techniques, as well as to assess the effectiveness of herbal and conventional toothpastes for plaque removal. @*Materials and Methods@#Thirty volunteers were divided into 3 groups. Each group was given a different toothpaste (from 2 herbal toothpastes and a conventional toothpaste) with which to brush their teeth for 21 days. Both initially and after brushing, dental plaque samples were collected, and plaque on the buccal surfaces of anterior teeth was scoredusing several imaging systems after staining with a disclosing agent. Specifically, digital dental photography, intraoral digital scanning, and FluoreCam imaging were employed to capture intraoral images. The Turesky Modified QuigleyHein Plaque Index was used for clinical examination and image analysis. Quantitative polymerase chain reactionanalyses and correlational assessments between clinical examination and imaging scores were conducted before and after toothpaste use. The Shapiro-Wilk test and Pearson correlations were utilized. @*Results@#The lowest mean value was observed in the clinical examination without staining, while the highest was obtained using the FluoreCam method. No significant change was found in the level of any microorganism assessed following toothpaste use (P<0.05), with the exception of a decrease in S. mutans levels after using conventional toothpaste (P<0.05). @*Conclusion@#Herbal toothpaste demonstrated plaque-removal effectiveness comparable to that of conventional toothpaste. The use of imaging methods for measuring plaque index has been suggested as a means to educate patients about plaque control and promote ongoing oral care.

Musculoskeletal and neurocognitive clinical significance of adult hypophosphatasia

Hypophosphatasia (HPP), also called Rathbun disease, is a rare genetic disorder that is caused by the loss-of-function mutation in the ALPL gene encoding tissue nonspecific alkaline phosphatase. Doctor Rathbun first described the case of a 3-week-old infant who presented with severe osteopenia, rickets, and multiple radio graphic fractures, and died shortly after of epileptic seizure and respiratory distress. The term “hypophosphatasia” was coined as the patients’ alkaline phosphatase levels were significantly low. Since then, our understanding of HPP has evolved, and now we appreciate causative genetic mutation and the broad spectrum of clinical presentation depending on the age of onset, severity, and skeletal involvement: perinatal, infantile, childhood, adult and odontohypophosphatasia. The new development of enzyme replacement with asfostase alfa has saved the lives of severe form of hypophosphatasia. However, it is still unclear and remains challenging how to manage adult HPP that often presents with mild and non-specific symptoms such as muscle pain, joint stiffness, fatigue, anxiety, or low bone mass, which are common in the general population and not necessarily attributed to HPP. In this review, we will present 3 unique cases of adult HPP and discuss the pathophysiology, clinical presentation particularly neuromuscular and neurocognitive symptoms and management of adult HPP.

Comparison of 3D accuracy of three different digital intraoral scanners in full-arch implant impressions

PURPOSE@#This in vitro study aimed to evaluate the performance of digital intraoral scanners in a completely edentulous patient with angled and parallel implants. @*MATERIALS AND METHODS@#A total of 6 implants were placed at angulations of 0°, 5°, 0°, 0°, 15°, and 0° in regions #36, #34, #32, #42, #44, and #46, respectively, in a completely edentulous mandibular polyurethane model. Then, the study model created by connecting a scan body on the implants was scanned using a model scanner, and a 3D reference model was obtained. Three different intraoral scanners were used for digital impressions (PS group, TR group, and CS group, n = 10 in each group). The distances and angles between the scan bodies in these measurement groups were measured. @*RESULTS@#While the Primescan (PS) impression group had the highest accuracy with 38 µm, the values of 104 µm and 171 µm were obtained with Trios 4 IOSs (TR) and Carestream 3600 (CS), respectively (P = .001). The CS scanner constituted the impression group with the highest deviation in terms of accuracy. In terms of dimensional differences in the angle parameter, a statistically significant difference was revealed among the mean deviation angle values according to the scanners (P .05). @*CONCLUSION@#A statistically significant difference was found among the three digital impression groups upon comparing the impression accuracy. Implant angulation affected the impression accuracy of the digital impression groups. The most accurate impressions in terms of both distance and angle deviation were obtained with the PS impression group.

Superexpressão Gênica PTEN em Tecidos Miocárdicos de Pacientes de Cirurgia de Revascularização Miocárdica / Overexpression of the PTEN Gene in Myocardial Tissues of Coronary Bypass Surgery Patients

Resumo Fundamento: A doença arterial coronariana é um distúrbio complexo que causa morte em todo o mundo. Um dos genes envolvidos no desenvolvimento dessa doença pode ser o PTEN. Objetivos: Nosso objetivo foi investigar a expressão gênica e proteica do PTEN em amostras de tecido e sangue retiradas de pacientes submetidos à cirurgia de revascularização miocárdica. Métodos: Foram realizados estudos moleculares no Centro de estudos do genoma humano e células-tronco da Universidade Erciyes (GENKOK). Amostras do apêndice atrial direito e de sangue foram coletadas da veia central de 22 pacientes submetidos à cirurgia de revascularização miocárdica antes de iniciar e terminar a circulação extracorpórea. A expressão do PTEN foi determinada usando PCR quantitativo em tempo real e análise de Western Blot. O nível de significância aceito foi de p<0,05. Resultados: Não houve diferença significativa na expressão gênica do PTEN em amostras de sangue coletadas antes e depois da circulação extracorpórea. Entretanto, foi observado um aumento substancial nos níveis de expressão gênica e proteica de P-PTEN e PTEN nas amostras de tecido. A expressão gênica miocárdica PTEN aumentou significativamente ao final da circulação extracorpórea. A expressão gênica do PTEN no período pós-circulação extracorpórea aumentou em comparação com o período pré-circulação extracorpórea, mas não foi um aumento significativo em comparação com sujeitos saudáveis do grupo de controle. Conclusão: Este estudo revelou pela primeira vez o papel do gene PTEN analisando a expressão de mRNA e de proteína em pacientes com revascularização miocárdica, que se manifesta tanto em tecido miocárdico quanto em amostras de sangue. O aumento dos níveis de PTEN pode ser um marcador no tecido miocárdico para pacientes com doença arterial coronariana.

Abstract Background: Coronary artery disease is a complex disorder that causes death worldwide. One of the genes involved in developing this disease may be PTEN. Objectives: This study aimed to investigate the PTEN gene and protein expression in tissue and blood samples taken from coronary bypass surgery patients. Methods: Molecular studies were performed at Erciyes University Genome and Stem Cell Center (GENKOK). Right atrial appendage and blood samples were taken from the central vein of 22 coronary bypass surgery patients before starting and ending cardiopulmonary bypass. PTEN expression was determined using quantitative real-time PCR and western blot analysis. The significance level was accepted as p<0.05. Results: There was no significant difference in the PTEN gene expression in blood samples taken before and after cardiopulmonary bypass. However, a substantial increase in both protein and gene expression levels of P-PTEN and PTEN was observed in the tissue samples. Myocardial expression of the PTEN gene was significantly increased at the end of the cardiopulmonary bypass. PTEN gene expression in the post-cardiopulmonary bypass period was increased when compared to the pre-bypass period, but it was insignificant when compared to healthy controls. Conclusion: This study first revealed the role of the PTEN gene by analyzing both mRNA and protein expression in coronary bypass patients, appearing in both myocardial tissue and blood samples. Increased levels of PTEN may be a marker in myocardial tissue for patients with coronary artery disease.

Comparação de Soluções Cardioplégicas em Cirurgia de Revascularização Miocárdica sobre Mecanismos de Autofagia e Apoptose / Comparison of Cardioplegic Solutions in Coronary Bypass Surgery Over Autophagy and Apoptosis Mechanisms

Resumo Fundamento A doença arterial coronariana (DAC) devido à isquemia miocárdica causa perda permanente de tecido cardíaco. Objetivos Nosso objetivo foi demonstrar o possível dano ao miocárdio em nível molecular através dos mecanismos de autofagia e apoptose em pacientes submetidos à cirurgia de revascularização miocárdica. Métodos Um grupo recebeu uma solução de cardioplegia Custodiol e o outro grupo uma solução de cardioplegia sanguínea. Duas amostras miocárdicas foram coletadas de cada paciente durante a operação, imediatamente antes da parada cardíaca e após a liberação do pinçamento aórtico. Foram avaliadas as expressões de marcadores de autofagia e apoptose. O nível de significância estatística adotado foi de 5%. Resultados A expressão do gene BECLIN foi significativa nos tecidos miocárdicos do grupo CS (p=0,0078). Os níveis de expressão dos genes CASPASE 3, 8 e 9 foram significativamente menores no grupo CC. Os níveis pós-operatórios de TnT foram significativamente diferentes entre os grupos (p=0,0072). As expressões dos genes CASPASE 8 e CASPASE 9 foram semelhantes antes e depois do pinçamento aórtico (p=0,8552, p=0,8891). No grupo CC, os níveis de expressão gênica de CASPASE 3, CASPASE 8 e CASPASE 9 não foram significativamente diferentes em amostras de tecido coletadas após pinçamento aórtico (p=0,7354, p=0,0758, p=0,4128, respectivamente). Conclusões Com nossos achados, acreditamos que as soluções CC e CS não apresentam diferença significativa em termos de proteção miocárdica durante as operações de by-pass.

Abstract Background Coronary artery disease (CAD) due to myocardial ischemia causes permanent loss of heart tissue. Objectives We aimed to demonstrate the possible damage to the myocardium at the molecular level through the mechanisms of autophagy and apoptosis in coronary bypass surgery patients. Methods One group was administered a Custodiol cardioplegia solution, and the other group was administered a Blood cardioplegia solution. Two myocardial samples were collected from each patient during the operation, just before cardiac arrest and after the aortic cross-clamp was released. The expressions of autophagy and apoptosis markers were evaluated. The level of statistical significance adopted was 5%. Results The expression of the BECLIN gene was significant in the myocardial tissues in the BC group (p=0.0078). CASPASE 3, 8, and 9 gene expression levels were significantly lower in the CC group. Postoperative TnT levels were significantly different between the groups (p=0.0072). CASPASE 8 and CASPASE 9 gene expressions were similar before and after aortic cross-clamping (p=0.8552, p=0.8891). In the CC group, CASPASE 3, CASPASE 8, and CASPASE 9 gene expression levels were not found to be significantly different in tissue samples taken after aortic cross-clamping (p=0.7354, p=0.0758, p=0.4128, respectively). Conclusions With our findings, we believe that CC and BC solutions do not have a significant difference in terms of myocardial protection during bypass operations.

Effects of nigella sativa oil on allergic rhinitis: an experimental animal study

Abstract Objectives: Nigella sativa oil is known antiallergic and immunomodulatory effects. We aimed to compare this oil with mometasone furoate, a topical steroid, on a rat model in the prevention of allergic rhinitis symptoms. Methods: A total of 28 two-to-four-month-old Wistar Hannover rats weighing 250-350 g were randomly divided into four groups of seven, which included control, allergic rhinitis, mometasone furoate, and Nigella sativa oil groups. Loss of cilia, an increase of goblet cells, vascular proliferation, inflammatory cell count, eosinophil infiltration, and the degree of hypertrophy in chondrocytes were assessed by light microscopy. Results: The frequency of nasal scratching in the Nigella sativa oil group was found to be significantly lower compared with the allergic rhinitis group (p < 0.05). Typical inflammatory changes seen in allergic rhinitis were not detected in the Nigella sativa oil group. No inflammation was observed in 85.7% of both the healthy control group and the Nigella sativa oil group. In addition, no inflammation was observed in 71.4% of the mometasone furoate group, and this difference was found to be significant compared with the control group (p < 0.05). In addition, eosinophil infiltration, cilia loss, chondrocyte hypertrophy, vascular proliferation, and goblet cell increase were found to be significantly decreased in the mometazone furoate and Nigella sativa oil groups compared to the allergic rhinitis group (p < 0.05). Conclusion: According to the findings obtained from this study, we found anti-inflammatory and anti-allergic effects of Nigella sativa oil as equally effective as mometasone furoate in the treatment of experimentaly generated allergic rhinitis. Level of evidence: IV.

Evaluation of the Rho-kinase gene expression and polymorphisms in adult patients with acute appendicitis: a differential impact of gender

SUMMARY OBJECTIVE: Acute appendicitis represents one of the most common causes of acute intra-abdominal emergencies worldwide. In this case-control study, we aimed to investigate associations of Rho-kinase gene expression and polymorphisms with acute appendicitis in a Turkish population. We also aimed to study the effects of gender on these parameters. METHODS: A total of 93 unrelated patients with acute appendicitis and 93 healthy controls in the Department of Emergency Medicine, Erciyes University, between June 2019 and June 2021 were included in this study. Genomic DNA was isolated from peripheral leukocytes, and the LightCycler 480 II real-time polymerase chain reaction was utilized to detect Rho-kinase1 gene rs35996865 and Rho-kinase2 gene rs2230774 (Thr431Asn) polymorphisms. Quantitative real-time polymerase chain reaction was applied to determine Rho-kinase1 and Rho-kinase2 gene expressions. RESULTS: There was a marked increase in Rho-kinase1, but not in Rho-kinase2, mRNA expression, and this increase was evident only in male patients (p=0.0008). No significant differences were found in allele and genotype frequencies for Rho-kinase1 gene rs35996865 and Rho-kinase2 gene rs2230774 polymorphisms between the patients with acute appendicitis and the control group. CONCLUSIONS: Our data imply that Rho-kinase1 (rs35996865) and Rho-kinase2 (rs2230774) gene variants are not risk factors for the development of acute appendicitis in the Turkish population. However, increased mRNA expression of the Rho-kinase1 gene in males indicated that Rho-kinase1 is involved in the pathogenesis of acute appendicitis in a gender-specific way.