COVID-19 Vaccination Rates and Factors Affecting Vaccine Hesitancy among Pregnant Women during the Pandemic Period in Turkey: A Single-Center Experience.

The new coronavirus disease (COVID-19), which was detected in the Wuhan region of China in 2019 and spread rapidly all over the world, was declared a pandemic by the WHO in 2020. Since then, despite widespread recommendations to prevent the spread of the disease and provide treatment for sick people, 6,573,968 people died all over the world, 101,203 of which in Turkey. According to the international adult vaccination guidelines, pregnant women have been recommended to get vaccinated against the new coronavirus disease, as well as influenza and tetanus, during pregnancy. Before this study, not enough information was available about the vaccination awareness and vaccination hesitancy rates of pregnant women living in Turkey. For this reason, we believe that our study will contribute to filling this gap in the literature. The main objective of this study was to investigate the vaccination rates of pregnant women in a local hospital in Turkey and the reasons for vaccine hesitancy in this patient group. The minimum sample size of the study was found to be 241, with 80% power, 0.2 effect size, and 95% confidence interval, at p < 0.05 significance level. We included 247 consecutive pregnant women who applied to the Samsun Training and Research Hospital Gynecology and Obstetrics Outpatient Clinics between January 2022 and April 2022. The researchers prepared a questionnaire by taking into account the characteristics of the local community. A preliminary survey with these questions was also conducted before starting the main study. The mean age of the pregnant women participating in the study was 28.7 ± 5.3 years, and the mean gestational age was 28.2 ± 7.9 weeks. Among the participants, 26.3% were university graduates or had a higher degree, and 17% were actively working; in addition, 93 (37.7%) of the 247 pregnant women had received the COVID-19 vaccine, 203 (82.2%) had received at least one dose of the tetanus vaccine, and only 1 (0.4%) person had been administered the influenza vaccine during pregnancy. The most common reason for COVID-19 vaccine refusal and hesitancy was safety concerns, while the low rates of tetanus and influenza vaccination were due to a lack of knowledge. These results show that it is important to inform and educate the pregnant population on this subject to improve their vaccination behavior.

HLA-B51 Impact on Clinical Symptoms in Behcet's Disease.

OBJECTIVE: To investigate the association of HLA-B51-positivity to clinical manifestations of Behçet's disease (BD). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Clinic of Rheumatology, Diskapi Education and Research Hospital, Health Sciences University, Turkey, from December 2018 to December 2020. METHODOLOGY: Patients who had HLA-B5 genetic results and fulfilled the international criteria for BD were included in the study. HLA-B51 status was determined and compared with the symptomatology. RESULTS: Mean age of 204 cases was 39.9±11.4 years. There were 52.5% female and 47.5% male patients. One hundred (61.7%) patients were HLA-B51-positive. The frequency of papulopustular lesions (PPL), ocular involvement, neurologic involvement, and vascular involvement was significantly higher in HLA-B51-positive patients compared to HLA-B51 negative patients (p=0.044, 0.012, 0.039, and 0.022 respectively). HLA-B51-positivity was found to be a significant risk factor for PPL (OR and 95% CI:1.946 and 1.044-3.629), ocular involvement (OR and 95% CI:2.399 and 1.165-4.938), and neurological involvement (OR and 95% CI:5.404 and 1.119-26.093). Significant risk factors for vascular involvement were male gender (OR and 95% CI:2.810 and 1.403-5.627) and low age of disease onset (OR and 95% CI:0.935 and 0.894-0.979). CONCLUSION: Ocular, vascular, and neurological involvements are more common in patients with BD with HLA-B51-positive. HLA-B51 was found to be an independent risk factor for papulopustular lesion, ocular and neurological involvement, while the male gender was found to be an independent risk factor for vascular involvement. KEY WORDS: Behcet syndrome / genetics, HLA-B51, Neurologic involvement, Ocular involvement, Vascular involvement, Vasculitis* / diagnosis.

COVID-19: mortality rates of patients on hemodialysis and peritoneal dialysis.

OBJECTIVE: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection might have a higher mortality rate in patients with end-stage renal disease due to immunosuppression. This study investigates the mortality rates of SARS-CoV-2 infection and the factors affecting mortality among patients who were on maintenance hemodialysis and continuous ambulatory peritoneal dialysis. MATERIALS AND METHODS: A total of 200 patients, including 157 maintenance hemodialysis and 43 continuous ambulatory peritoneal dialysis patients followed in our hospital, were included in the study. The patients' sociodemographic characteristics, comorbidities, history of SARS-CoV-2 infection in the previous year, death event, source of death (SARS-CoV-2 or not), presence of hospitalization due to SARS-CoV-2 infection, need for intensive care unit, need for ventilatory support in intensive care unit were obtained from the clinical file records. RESULTS: 85 of the 200 patients had a history of SARS-Cov-2 infection during the last 12 months. Forty-two (49.5%) patients with SARS-CoV-2 infection were hospitalized. Patients with SARS-CoV-2 had longer dialysis time, increased mortality, and significantly higher comorbidities such as coronary artery disease, congestive heart failure. Besides, heart failure and hypertension were the determining factors in the risk factor analysis for SARS-CoV-2 infection. In dialysis patients, the mortality rate in the last year, due to all causes, including SARS-CoV-2 infection, was 23% while the mortality rate due to "SARS-CoV-2 infection only" was 13%) (p > 0.05). Our findings are important in guiding clinical decision-making and informing the public and health authorities about the risk of death associated with COVID-19 in this patient group.

The Effect of the COVID-19 Pandemic on Vaccination Behaviour of Individuals over the Age of 65 Years in Turkey: Single-Centre Experience.

The aim of this study is to evaluate the awareness of individuals over 65 years of age who have had the COVID-19 vaccine at the Samsun Research and Training Hospital and to evaluate whether the COVID-19 pandemic affected the vaccination behaviour in the geriatric age group. A total of 290 people who were vaccinated against COVID-19 at the Samsun Training and Research Hospital between 16 April 2021 and 16 April 2022 and volunteered to participate in the study were included. The questionnaire form was created by the researchers. According to the national and global guidelines, the seasonal influenza vaccine, Td or Tdap vaccines (tetanus, diphtheria, and pertussis), shingles vaccine, and pneumococcal conjugate vaccine (PCV15 or PCV20), have been recommended to all adults over the age of 65. It was questioned whether the participants had the vaccines recommended for them before and after the pandemic, if they were not vaccinated, what were the reasons, and whether the COVID-19 pandemic affected the general view on vaccination in this age group. Demographic data and comorbidities were also recorded. After each response that showed that the participant was not vaccinated, reasons were investigated with new questions to find out the causes of vaccine refusal or vaccine hesitancy. Finally, all participants were asked whether they would have the relevant vaccinations when offered. It was shown that 282 (94.3%) of the 299 people who participated in the study were considering getting a regular COVID-19 vaccine from now on, while 84.3% of the participants mentioned that the COVID-19 pandemic had a positive effect on their general vaccination behaviour. While 39 (13%) people stated that their view on vaccination was not affected by the pandemic, 8 (2.7%) people stated that it was negatively affected. The most common reason about low vaccination rates before the pandemic was a lack of enough knowledge about the recommended vaccines. The pandemic increased the vaccination awareness among the adult population. We think that vaccination rates may be improved by education of the geriatric population on this subject.

Angiotensin-converting enzyme-1 gene insertion/deletion polymorphism may be associated with COVID-19 clinical severity: a prospective cohort study.

BACKGROUND: Angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism may play a role in the pathogenesis of coronavirus-19 disease (COVID-19). OBJECTIVES: Investigate the relationship between ACE I/D polymorphism and the clinical severity of COVID-19. DESIGN: Prospective cohort study. SETTING: Tertiary care hospital. PATIENTS AND METHODS: The study included COVID-19 patients with asymptomatic, mild, and severe disease with clinical data and whole blood samples collected from 1 April 2020 to 1 July 2020. ACE I/D genotypes were determined by polymerase chain reaction and agarose gel electrophoresis. MAIN OUTCOME MEASURE: ACE DD, DI and II genotypes frequencies. SAMPLE SIZE: 90 cases, 30 in each disease severity group. RESULTS: Age and the frequency of general comorbidity increased significantly from the asymptomatic disease group to the severe disease group. Advanced age, diabetes mellitus and presence of ischemic heart disease were independent risk factors for severe COVID-19 [OR and 95 % CI: 1.052 (1.021-1.083), 5.204 (1.006-26.892) and 5.922 (1.109-31.633), respectively]. The ACE II genotype was the dominant genotype (50%) in asymptomatic patients, while the DD genotype was the dominant genotype (63.3 %) in severe disease. The ACE II geno-type was protective against severe COVID-19 [OR and 95% CI: .323 (.112-.929)]. All nine patients (8.9%) who died had severe disease. CONCLUSIONS: The clinical severity of COVID-19 infection may be associated with the ACE I/D polymorphism. LIMITATIONS: Small sample size and single center. CONFLICT OF INTEREST: None.

Associations between the radiographic phenotypes and the presence of metabolic syndrome in patients with knee osteoarthritis.

BACKGROUND: We aimed to investigate the associations between the radiographic phenotypes and the presence of metabolic syndrome (MetS) in patients with knee osteoarthritis (OA). METHODS: We evaluated women age 40 and over who presented to our outpatient clinics with knee pain and fulfilled the clinical and radiographic criteria for the classification of idiopathic OA of the knee. Patients were categorized into two groups concerning dominant radiographic phenotype. We included consecutive 50 patients in each group. All patients were evaluated in terms of MetS according to the revised diagnostic criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), as well as the World Health Organization (WHO). RESULTS: Overall, MetS prevalence was found to be 79% according to the NCEP ATP III-MetS criteria and 65% according to the WHOMetS criteria. Prevalence of MetS was higher in the joint space narrowing (JSN)-dominant group compared to the osteophyte (O)- dominant knee OA group, but the difference did not reach statistical significance. However, in subgroup analysis (54 patients) in which we excluded patients with a past medical history of type 2 diabetes mellitus (DM), the prevalence of NCEP ATP III-MetS was statistically significantly higher in the JSN-dominant group compared to the O-dominant group [22 (75.9%) vs. 12 (48%), respectively, p = 0.03]. Logistic regression analysis in the subgroup demonstrated that the presence of NCEP ATP III-MetS was an independent risk factor for JSN-dominant knee OA phenotype [OR and 95% CI = 3.48 (1.09-11.13)]. DISCUSSION: The prevalence of MetS is quite high in patients with knee OA and is particularly pronounced in patients with JSNdominant radiographic phenotype. Moreover, our results suggest that MetS is an independent risk factor for JSN-dominant knee OA in patients with no past medical history of DM.

[Evaluation of Patients Diagnosed with COVID-19 in Terms of Risk Factors]. / COVID-19 Tanili Hastalarin Risk Faktörleri Açisindan Degerlendirilmesi.

Coronaviruses are RNA viruses that can cause disease in the upper and lower respiratory tract in humans and animals. Lately, a new coronavirus causing pneumonia cases was detected in Wuhan, China in December 2019. Soon after, the name of the virus was identified as the "severe acute respiratory syndrome coronavirus-2", and the World Health Organization named the disease coronavirus disease-2019 (COVID-19). In our country, the first cases began to appear in the second week of March. In this study, we aimed to investigate the demographic characteristics and risk factors of patients with the diagnosis of COVID-19. A total of 100 patients (53 female and 47 male) were included in our study. The patients included in the study were randomly selected from the registration system and their information was evaluated retrospectively. The mean age of the patients was 54.42 (Age range= 20-90). When the risk factors for catching the disease were evaluated; it was determined that there was at least one risk factor in 46 patients; 30 patients had close contact with the COVID-19 patient in the social environment (30%) and 16 patients had a travel history outside the city in the last 14 days (16%). The most common symptoms in our patients were; cough (93%), fever (42%), dyspnea (22%), weakness (8%), sore throat (7%), diarrhea (6%), headache (5%) and sputum (2%). The most common comorbid conditions in our patients were detected as hypertension (42%), diabetes mellitus (DM) (21%), congestive heart failure (10%), allergic asthma (7%), chronic obstructive pulmonary disease (6%), rheumatoid arthritis (3%), coronary artery disease (2%), solid organ tumour (2%), depression (1%) and epilepsy (1%). The mean age of our 15 patients who were monitored in intensive care unit was 65 y (± 11.46), the mean age of 85 patients followed in the service was 52.55 (± 16.35) and this difference was statistically significant (p= 0.006). When these two groups were compared in terms of comorbid diseases, the presence of DM was 40% higher (n= 6) in intensive care patients, and this difference was statistically significant (p= 0.05). In addition, the majority [11 patients (73%)] of the patients hospitalized in the intensive care unit were male (p= 0.03). When smoking was evaluated as a risk factor for serious illness, 4 of 11 patients (26%) in intensive care unit had a smoking history, while none of the patients who have died due to COVID-19 had a smoking history. These findings suggested to us that smoking does not increase the severity of COVID-19 disease. As a result, knowledge about the disease should be increased rapidly by sharing the studies on risk factors, transmission routes and clinical features of COVID-19 infection, which affects the whole world.

25-Hydroxy vitamin D level is associated with sleep disturbances in patients with chronic kidney disease on hemodialysis: a cross-sectional study

Background/aim: Deficient levels of vitamin D are an important factor in the pathogenesis of some neurodegenerative diseases. The aim of this study is to determine the relationship between vitamin D deficiency and depression status and sleep disorders of patients on dialysis. Materials and methods: In this cross-sectional study, 121 hemodialysis patients were enrolled. All patients had been on hemodialysis for at least six months at the time of the study. Sleep quality and depression status were measured by using specific inventories. All the patients filled out Pittsburg Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), and gave blood samples. Vitamin D levels were measured for 121 patients, and statistical analysis was done by using SPSS. Results: Regression analyses demonstrated that low levels of 25(OH)D and high BDI score were independent risk factors for poor sleep quality [ORs were 0.668 (0.566­0.789), 1.080 (1.001­1.164), and 1.080 (1.001­1.164), respectively]. Conclusion: Our results suggest that deficiency of 25(OH)D is an important independent risk factor for poor sleep quality in hemodialysis patients.

Macular ganglion cell-inner plexiform layer thickness for detection of early retinal toxicity of hydroxychloroquine.

PURPOSE: This study evaluated the macular ganglion cell-inner plexiform layer (GC-IPL) thickness using spectral-domain (SD) optical coherence tomography (OCT) in patients with chronic exposure to hydroxychloroquine (HCQ). METHODS: A total of 90 patients (90 eyes) treated with HCQ for at least 5 years and normal controls were included in the study. A fundus examination, automated threshold perimetry, and GC-IPL thickness measurements using the Cirrus high-definition OCT ganglion cell analysis algorithm were performed in all patients treated with HCQ. Average, minimum, and sectorial macular GC-IPL thicknesses were compared between the patients and controls. RESULTS: There was no statistically significant difference in age or sex between the groups. The anterior segment and fundoscopy were normal in all patients and controls. Visual field (VF) testing was normal in all patients. The average, minimum, and sectorial macular GC-IPL thicknesses were significantly lower in patients than those in control subjects. CONCLUSIONS: There was significant thinning of the macular GC-IPL in the absence of clinically evident HCQ-related retinopathy and VF abnormalities. Measurements of the macular GC-IPL thickness using SD-OCT may therefore be useful in the early diagnosis and in monitoring the progression of retinal changes in patients receiving long-term HCQ therapy.

The effect of caffeic acid phenethyl ester (CAPE) on tympanosclerosis.

OBJECTIVE: To investigate the effects of caffeic acid phenethyl ester (CAPE) on tympanosclerosis. MATERIALS AND METHODS: Thirty-two male Sprague Dawley rats were separated into 4 groups as CAPE (n = 10), alcohol (n = 10), control (n = 8) and normal (n = 4) groups. All tympanic membranes except normal group were myringotomised and type 3 Streptococcus pneumoniae strains was injected into their middle ears. Myringotomies were repeated for 5 weeks. Intraperitoneal (i.p) CAPE were administrated to the CAPE group at 10 µmol/kg/day and 10% ethyl alcohol administrated to the alcohol group for 5 weeks. The control group were left untreated. Findings of myringosclerosis were recorded by otomicroscope at sixth week. Then, all rats were sacrificed and tympanic membrane thickness and severity of middle ear mucosal inflammation evaluated histopathalogically. RESULTS: Severity of myringosclerosis was significantly higher in the alcohol and control groups compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The tympanic membrane thickness measured in the alcohol and control groups were significantly higher compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The severity of inflammation in the middle ear mucosa was significantly higher in the alcohol and control groups compared to the CAPE group (respectively, p < 0.001, p = 0.03). The severity of inflammation in the middle ear mucosa was not significant between alcohol and control groups (p = 0.30). CONCLUSION: CAPE has anti-inflammatory and antioxidant effects on the development of MS in myringotomized rats, so reduces the severity of tympanosclerosis.

Central line-associated blood stream infections: characteristics and risk factors for mortality over a 5.5-year period.

BACKGROUND/AIM: Central line-associated bloodstream infections (CLABSIs) are associated with substantial morbidity and mortality and the infection rates vary in a wide range1397645907(high: 62.5%; low: 20%) in developing countries. We aimed to investigate the characteristics and the risk factors for mortality in patients with CLABSIs in intensive care units (ICUs) and provide the relevant data. MATERIALS AND METHODS: The electronic medical records database and file records obtained through active surveillance by an infection control committee of a hospital were screened to identify patients with CLABSIs hospitalized from January 2008 through July 2013. RESULTS: A total of 166 CLABSI episodes in 158 patients out of 17,553 on 38,562 catheter and 94,512 hospitalization days were evaluated. The infection developed in catheterized patients at a median of 14 days (range 2-88), and the highest infection rate with 13.4% (n = 20) was the femoral region among the places where the catheter was inserted. Of the patients catheterized, 54.4% survived whereas 45.6% died. In patients having Candida infection, the mortality was significantly higher. High APACHE II scores and Candida infections were found to be significant risk factors associated with mortality. CONCLUSION: APACHE II scores and bloodstream infection with Candida species were the most powerful predictors of mortality. In ICU practice, health-care givers must consider the emerging role of Candida for both invasiveness and mortality.

Associations between obesity and the radiographic phenotype in knee osteoarthritis.

BACKGROUND/AIM: Investigation of the association between obesity and the distinction of radiographic patterns in knee osteoarthritis. MATERIALS AND METHODS: Seven hundred and thirty-four women underwent weight-bearing antero-posterior knee radiography. Osteophytes and joint space narrowing (JSN) were graded according to the OARSI atlas. Each subject was assigned to one of the following groups with respect to the maximum score: osteophyte-dominant, indeterminate, JSN-dominant, and radiographically normal. RESULTS: Obese patients had a significantly more frequent osteophyte-dominant pattern compared to nonobese subjects (74.5% and 38%, respectively, P < 0.001). Logistic regression analysis demonstrated that obesity had a stronger association with an osteophyte-dominant pattern compared to a JSN-dominant pattern (OR and 95% CI = 7.16 (3.15-16.26) and 1.63 (0.96-2.78), respectively). Age had a very weak effect on the distinction to an osteophyte-dominant pattern and no effect on JSN dominance (OR and 95% CI = 1.1 (1.06-1.15) and 1.02 (0.99-1.05), respectively). CONCLUSION: There might be an association between obesity and the radiographic phenotype in patients with knee osteoarthritis. The findings suggest that the association between obesity and the osteophyte formation is stronger than that of JSN.

Is Pseudoexfoliation Syndrome a Risk Factor for Cerebro Vascular Disease?

PURPOSE: To determine the relationship between cerebro vascular disease and pseudoexfoliation syndrome. MATERIALS AND METHODS: This cross-sectional case control study consisted of 50 patients with ischemic-type cerebro vascular disease and 50 control subjects. All subjects were investigated for diabetes mellitus and hypertension status and underwent a detailed ophthalmic examination. A diagnosis of pseudoexfoliation syndrome was made if characteristic greyish particulate matter was found on the anterior lens capsule after pupillary dilatation by slit-lamp examination. All subjects were compared in terms of pseudoexfoliation syndrome, diabetes mellitus, and hypertension. Pearson Chi Square and Student's t test were used for statistical analysis. Logistic regression analyses of the risk factors between groups were also made. RESULTS: The presence of pseudoexfoliation syndrome was significantly higher in patients with cerebro vascular disease when compared to the control subjects (p = 0.02). The frequency of diabetes mellitus was similar between the two groups. Arterial hypertension was significantly more frequent in the patient group when compared to the control subjects (p < 0.01). The logistic regression analysis showed that both pseudoexfoliation syndrome and hypertension were significantly associated with cerebro vascular disease. CONCLUSION: In the present study, we found that pseudoexfoliation syndrome frequency was found to be higher in patients with cerebro vascular disease than in control subjects. A slit-lamp examination of the eye could be an important marker that indicates the risk of cerebro vascular disease. We recommend an evaluation of all subjects with pseudoexfoliation syndrome for the presence of cerebro vascular disease. Longitudinal studies with larger populations are needed to confirm this relationship.

Temporomandibular joint findings in patients with rheumatoid arthritis, ankylosing spondylitis, and primary Sjögren's syndrome.

AIM: The aim of the present study was to investigate the prevalence of temporomandibular joint (TMJ) symptoms in rheumatoid arthritis (RA), primary Sjögren's syndrome (pSS), and ankylosing spondylitis (AS) patients. METHODS: The present study consisted of 79 individuals with various rheumatic disease (study group: 39 with RA, 17 with AS, 23 with pSS) and 79 age- and sex-matched healthy controls (control group). Subjective symptoms of the TMJ were recorded by means of a questionnaire. And stomatognathic examination was then performed. RESULTS: The prevalence of subjective symptoms in patients with rheumatic disease (73.4%) were significantly higher than that of the controls (22.8%; P<.05). The most common objective symptoms were pain during lateral TMJ palpation (29.1% of patients overall, 8.9% of controls) and mandibular movements (19% of patients overall, 2.5% of controls), and muscle pain during palpation (38% of patients overall, 3.8% of controls). They were significantly higher in all of the rheumatic patients than the controls (P<.05). There was not a statistically-significant difference in the values for mandibular movements between the study and control groups (P>.05, Mann-Whitney U test). CONCLUSIONS: TMJ symptoms were observed to be higher in the patients with RA, AS and pSS than the control group. Dentists and rheumatologists should be aware of TMJ symptoms in patients with rheumatic diseases.

Old-scar mass and changing surgical perspective: Sarcoidosis.

Sarcoidosis is a systemic inflammatory disease of an unknown etiology. Skin is involved in 25% of all cases, and 29% of them present as a scar sarcoidosis. Asymptomatic old-scar masses are generally regarded as a foreign body reaction by surgeons and often result in excisional biopsy. We describe a case of a patient who developed sarcoidosis in a 34-year-old appendectomy scar and adjacent inguinal lymph nodes without any local or systemic symptom and radiologic finding. Surgeons should not underestimate the importance of such lesions as a simple condition. Scar sarcoidosis may resolve spontaneously, or the treatment with some topical agents is effective. Furthermore, scar sarcoidosis may be the initial manifestation of systemic sarcoidosis.

Abdominal pain may dominate the scene of idiopathic aortitis.

A 59-year-old man suffering from abdominal pain and having high acute phase reactants was admitted to hospital. Aortitis was discovered incidentally with magnetic resonance that was performed for another prediagnosis. Steroid and azathioprine combination was unsuccessful for remission and preventing relapses. However, steroid and methotrexate combination was successful for clinical and laboratory remissions. Also, the iliac artery occlusion was improved with stent implementation. In general, isolated idiopathic aortitis is a very rare entity and hard to be diagnosed. In this case, we describe a patient with aortitis that has only abdominal pain and treated with steroid and methotrexate combination.

MEFV gene mutations and its impact on the clinical course in ulcerative colitis patients.

Ulcerative colitis (UC) is an inflammatory disease of the colonic mucosa. The presence of gene responsible for FMF, MEFV, which frequently causes inflammation, may aggravate the clinical course of UC. We aimed to determine the prevalence of MEFV mutations in UC patients and its impact on the clinical course. Four groups were formed as group 1 UC with distal disease, group 2 UC with pancolonic disease, group 3 UC with total colectomy, and group 4 Rheumatoid Arthritis (RA) patients. Eleven mutations of FMF gene were investigated. The mean age of group 1, 2, 3, and 4 were 46.7 ± 13.9, 43.8 ± 12.9, 44.8 ± 14.2, and 45.8 ± 10.9 years, respectively. The mutations were identified in 19 of the 54 UC patients (35.2%). Homozygous E148Q in 2 patients (3.7%) and heterozygous in 17 patients (31.5%) (E148Q 11.1%, M694V 5.6%, V726A 5.6%, K695R 1.8%, M680I 1.8%, and compound heterozygous 5.6%) were determined. Frequencies of MEFV mutations in group 1, 2, and 3 were 30, 27.3, and 58.3%, respectively. The mutations were identified in 3 of the 20 RA patients (15%). All of them were heterozygous. The rate of MEFV mutations were higher in group 3 than in group 4 (P = 0.018), and the number of attacks that were treated with steroid in all UC patients with mutation positive was higher than in mutation negative (P = 0.016). FMF gene mutations may be identified in UC patients up to 58.3%. It may be suggested that the UC patients with severe form should be identified for MEFV mutations before the judgment of colectomy.

Circulating hepcidin in the crossroads of anemia and inflammation associated with rheumatoid arthritis.

OBJECTIVE: To investigate the role of circulating hepcidin, which is a homeostatic regulator of iron metabolism and a mediator of inflammation, in anemia associated with rheumatoid arthritis. METHODS: Forty patients with rheumatoid arthritis (19 with anemia and 21 without anemia), 12 patients with iron deficiency anemia and 14 healthy adults were studied. Serum hepcidin levels were analyzed with hepcidin prohormone solid phase enzyme-linked immunosorbent assay. RESULTS: The mean serum hepcidin levels were significantly higher in patients with rheumatoid arthritis with anemia compared to healthy adults and those with iron deficiency anemia. The active rheumatoid arthritis group had significantly higher mean serum hepcidin levels than the inactive rheumatoid arthritis group. In the rheumatoid arthritis group, serum hepcidin levels were positively correlated with disease activity, but inversely correlated with hemoglobin levels. The serum hepcidin level was found to be a significant predictor for hemoglobin level. CONCLUSION: Serum hepcidin levels are closely associated with disease activity in rheumatoid arthritis patients and might play a role in the pathobiology of chronic disease anemia associated with rheumatoid arthritis.

Apolipoprotein E gene polymorphism in nonalcoholic fatty liver disease.

The aim of this study was to evaluate the relationship between apolipoprotein E gene polymorphism and nonalcoholic fatty liver disease. The study group consisted of 237 nonalcoholic fatty liver disease patients who were detected by ultrasonography and 201 controls with ultrasonographically normal livers. DNA amplifications were performed by polymerase chain reaction technique and apolipoprotein E genotypes were evaluated after digestion with CfoI restriction enzyme. Serum levels of glucose, lipids, lipoproteins, and apolipoproteins were measured in all subjects. Additionally, viral hepatitis markers, liver enzymes, and body mass index were assessed. Patients were found to have significantly higher triglyceride, glucose, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase levels and lower high-density lipoprotein cholesterol and apolipoprotein (a) levels than controls (P<0.05). There were no statistically significant differences in genotypes and allele frequencies between all patients and controls. Comparing nonobese patients with controls, the frequencies of allele epsilon2 and genotype epsilon2epsilon3 were statistically significantly different in the controls (P=0.04 and P=0.01, respectively). In conclusion, occurrence of the epsilon2 allele and epsilon2epsilon3 genotype may be protective against development of nonalcoholic fatty liver disease.