Comparison of immunogenicity for Sinovac-CoronaVac vaccine vs. natural infection during cancer treatment.

OBJECTIVE: Efficacy of the COVID-19 vaccines in cancer patients, especially during their active treatment, are lacking. Most of the studies in the literature compared the immunity in cancer patients with a cross-sectional cohort or retrospectively. Our study investigated Sinovac-CoronaVac COVID-19 vaccine immunogenicity and compared it with natural COVID-19 disease in cancer patients during their cancer therapy. PATIENTS AND METHODS: A total of 111 patients with cancer and who are on active treatment were included in the study. This is a single-center study and was designed prospectively. Two group of patients were included in the study, natural disease and vaccinated group. RESULTS: A total of 111 patients were included in the study, 34 of whom had natural COVID-19 disease. Antibody levels following the first dose vaccine were 0.4 (0-1.9) U/ml while after the second dose of vaccine were 2.6 (1.0-7.25) U/ml. Immunogenicity levels were 82.4% in the natural disease group and 75.8% in the vaccinated group after the second shot of the vaccine. Immunogenicity rate was significantly higher in non-chemotherapy (receiving immunotehrapy/targeted therapy or biologic agent) group compared to chemotherapy drug (92.9% vs. 63.3%, p=0.004). There was a difference between the antibody levels following the first and second vaccination [median (IQR): 0.3 (0-1.0) and 3.3 (2.0-6.7), p=0.001, respectively]. CONCLUSIONS: The present study revealed that the Sinovac-CoronaVac vaccine showed an acceptable immunogenicity following two shots in cancer patients who were receiving active systemic therapy. On the other hand, natural disease immunogenicity was higher than vaccinated group.

Oral health status and its relation with medication and dental fear in children with attention-deficit hyperactivity disorder.

OBJECTIVE: The objective of this study was to determine the ora-dental health and its relation with medication and dental fear in a group of Turkish children with attention-deficit hyperactivity disorder (ADHD). SUBJECTS AND METHODS: The levels of dental fear of children were determined with The Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). The oral and dental health evaluation was performed. This study included a total of 117 children aged between 6 and 15 years and they were examined under two groups as "ADHD" (n = 59) and "Control" (n = 58). Ora-dental health variables were compared between the groups and were also analyzed in accordance with dental fear and medication. RESULTS: ADHD children and the control group exhibited similar CFSS-DS scores (15-32). No significant differences existed in df(t)/df(s), DMF(T)/DMF(S), d/D values, and presence of the white spot lesions. ADHD children's Mutans streptococci and Lactobacillus quantities were found significantly higher than the control group. The incidence of parafunctional habits of the ADHD children was also found high. CONCLUSIONS: ADHD children that were medicated exhibited similar dental caries prevalence and periodontal health status. Although ADHD group had similar dental-periodontal health status and dental fear level with the control group and using ADHD medicines did not make a significant effect on the ora-dental health parameters, the patients should be carefully followed up because they were categorized in high caries risk groups.

The effects of repeated filling cystometries on cystometric variables in spinal cord-injured patients with overactive detrusor, who utilize different type of urine drainage methods.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: Our aim was to compare the effects of repeated cystometric measurements in spinal cord injury (SCI) patients with neurogenic detrusor overactivity (NDO) who use indwelling catheters (IDC) or intermittent catheterization (IC). SETTING: Turkey. METHODS: A total of 20 SCI patients with NDO, 9 patients on IC and 11 on IDC for at least two consecutive months were included. After emptying the bladder, first involuntary detrusor contraction volume (1stIDCV), cystometric bladder capacity (CC), bladder compliance and maximum detrusor pressure (MPdet) were assessed by filling it with sterile physiological saline at room temperature at a continuous rate of 30 ml min(-1). The bladder was re-emptied after the process and a second filling cystometry was performed in the same way. RESULTS: When all study population were taken into account, 1stIDCV and CC measures were significantly increased in the second cystometry compared with the first cystometry (P=0.001 and P=0.022, respectively), whereas there was no statistically significant difference on bladder compliance and MPdet measures between the first and the repeated cystometry. There was no statistically significant difference on 1stIDCV, CC and bladder compliance measures between the first and the repeated cystometries for IC group, whereas there was statistically significant increase on these measures in the IDC group (P=0.003, P=0.008 and P=0.022, respectively). In addition there was no statistically significant difference on MP(det) measures between the first and the repeated cystometries for both the urine drainage methods. When IC and IDC groups were compared according to mean values of differences in 1stIDCV, CC and bladder compliance measures between the two cystometries, the IDC group had a statistically significant increase in all parameters when compared with the IC group in the second cystometry performed (P=0.001, P=0.003 and P=0.048, respectively). CONCLUSION: Repeated cystometric measurements in SCI patients with NDO lead to an increase in 1stIDCV and CC. However, when the type of urine drainage method is taken into account, although repeated filling cystometry leads to an increase in 1stIDCV, MCC and bladder compliance in patients with IDC, it does not cause a difference in patients on IC.

Intermittent catheterization in patients with traumatic spinal cord injury: obstacles, worries, level of satisfaction.

OBJECTIVES: The aim of this study is to examine the obstacles in people with traumatic spinal cord injury (SCI) face performing intermittent catheterization (IC), also their worries and level of satisfaction. METHODS: Two hundred sixty-nine patients performing IC for at least 3 months were asked to fill-out a questionnaire about their opinions on IC. RESULTS: In total, 69.5% of patients performed IC themselves, 10.4% had performed by their mothers, 7.8% by another caregiver and 7.4% by their spouse. For the 72 (26%) patients unable to apply IC, reasons were insufficient hand function (56.1%), being unable to sit appropriately (35.4%) and spasticity (8.5%). In all, 70% of male patients had insufficient hand function, 20% could not sit and 10% had spasticity while 56.3% of female patients could not sit, 37.5% had insufficient hand function and 63% had spasticity. Difference between sexes was found to be statistically significant (P<0.05). Worries patients had when starting IC were fear of being dependent on IC (50.2%), accidentally injuring self (43.8%), embarrassment (43.2%), causing an infection (40.2%), bleeding (32.7%), fear of feeling pain (30.2%) and hygiene (24.7%). More women felt embarrassment; other items were similar in both sexes. In all, 46.9% of patients had urinary incontinence in intervals. CONCLUSION: In total, 69.5% of patients performed IC themselves. Men's most common obstacle was insufficient hand function while women's was being unable to sit appropriately. Patients' most common worries were being dependent on IC for life. In all, 46.9% had incontinence in intervals; 47.9% said IC improved their life quality; and 97.4% preferred IC over continuous catheterization.

Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up.

STUDY DESIGN: Multi-center, cross-sectional study. OBJECTIVES: Our aim was to evaluate the treatment methods and follow-up of neurogenic bladder in patients with traumatic spinal cord injury retrospectively using a questionnaire. SETTING: Turkey. METHODS: Three hundred and thirty-seven patients who had spinal cord injury for at least 2 years were enrolled from six centers in the neurogenic bladder study group. They were asked to fill-out a questionnaire about treatments they received and techniques they used for bladder management. RESULTS: The study included 246 male and 91 female patients with a mean age of 42±14 years. Intermittent catheterization (IC) was performed in 77.9% of the patients, 3.8% had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6% performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No gender difference was found regarding the techniques used in bladder rehabilitation (P>0.05). Overall, 63.2% of patients used anticholinergic drugs; anticholinergic drug use was similar between genders (P>0.05). The most common anticholinergic drug used was oxybutynin (40.3%), followed by trospium (32.6%), tolterodine (19.3%) darifenacin (3.3%), propiverine (3.3%) and solifenacin (1.1%). The specialties of the physicians who first prescribed the anticholinergic drug were physiatrists (76.2%), urologists (22.1%) and neurologists (1.7%). Only four patients had previously received injections of botulinum-toxin-A into the detrusor muscle and three of them stated that their symptoms showed improvement. Most of the patients (77%) had regular follow-up examinations, including urine cultures, urinary system ultrasound and urodynamic tests, when necessary; the reasons for not having regular control visits were living distant from hospital (15.3%) and monetary problems (7.7%). Of the patients, 42.7% did not experience urinary tract infections (UTI), 36.4% had bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes per year and 5% had ⩾3 clinical UTIs. The clinical characteristics of patients with and without UTI (at least one symptomatic UTI during 1 year) were similar (P>0.05). The frequency of symptomatic UTI was similar in patients using different bladder management techniques (P>0.05). CONCLUSION: The most frequently used technique for bladder rehabilitation in patients with SCI was IC (77.9%). In all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most commonly used drug. Also, 77% of patients had regular control visits for neurogenic bladder; 42.7% did not experience any UTIs.

Parkinsonism in elderly rheumatoid arthritis patients.

OBJECTIVE: The incidences of extrapyramidal symptoms and Parkinson's disease were reported to be increased in patients with rheumatoid arthritis (RA). In this study we aimed to explore the frequency of the symptoms of Parkinsonism among RA patients older than 60 years. PATIENTS AND METHODS: 30 (6 males, 24 females) consecutive RA patients, followed at a rheumatology outpatient clinic, who were 60 years of age or older; 23 patients who were diagnosed as PD and 50 sex and age matched healthy controls were included to the study. All participants were examined for the motor and non-motor findings of Parkinsonism including bradykinesia, rigidity, tremor, postural abnormality, upper limb sway abnormality, gait impairment, decrease in facial expression, seborrhea, slowing of speech and impairment in the self care. RESULTS: When the RA, PD cases and healthy control group were compared for bradykinesia, rigidity, tremor, posture, upper limb sway, gait impairment, facial expression, seborrhea, speech and self care; highly significant differences were seen for all parameters. Two out of the 30 RA cases (6,7%) were diagnosed as Parkinson's disease. CONCLUSIONS: The signs of Parkinsonism and Parkinson's disease were found more frequent in elderly RA cases as compared to healthy controls.

Hepatic and renal functions in growing male rats after bisphenol A and octylphenol exposure.

This study aimed to determine the effects of 13-week bisphenol A (BPA) and octylphenol (OP) exposure on the liver, kidney, and spleen of growing male rats. A total of 29 male Wistar rats aged 4-5 weeks were divided into five groups. The treatment groups were given low-dose (125 mg/kg bw/day) or high-dose (250 mg/kg bw/day) BPA or OP. These compounds were dissolved in corn oil and given via oral route for 13 weeks. Rats in the control group received corn oil for 13 weeks, as well. After 13 weeks of treatment, blood samples were analyzed for biochemical parameters. Tissue samples from the liver, kidney, and spleen were histopathologically and histomorphometrically examined. Liver tissue specimens were also stained by immunohistochemically; the number of apoptotic cells was counted, and the apoptotic indices were calculated. There were significant differences between the control and treatment groups with respect to the following parameters: body weight, relative left kidney weight, and total protein, glucose, and alkaline phosphatase levels. Edema and parenchymal degeneration in the liver and tubular degeneration in the kidney were more frequent in the treatment groups. The control and treatment groups were comparable with respect to the frequency of histopathological lesions in the spleen. Glomerular histomorphometry revealed no significant differences between the control and treatment groups. No significant differences existed between the control and treatment groups with respect to the number of apoptotic cells and apoptotic indices. Subchronic exposure to BPA and OP induced functional and structural changes in the liver, kidney, and spleen of growing male rats.

Hepatitis B virus vaccination in children with steroid sensitive nephrotic syndrome: immunogenicity and safety?

We investigated the efficacy and safety of Hepatitis B vaccine (HBVac) in steroid sensitive nephrotic syndrome (SSNS) children. 41 patients with SSNS and 30 controls were vaccinated with HBVac(Engerix B(®)). Patients were divided into 3 subgroups:full dose steroid users, alternate-day steroid users and steroid non-users. Seroconversion rate was lower in steroid users than non-users at the 6th(p=0.015) and 12th(p=0.036) months. Antibody to Hepatitis B surface antigen(HBsAb) titers were significantly different between subgroups and controls at the 15th month. However, HBsAb and response rates were not different between subgroups at the 12th and 15th months (p>0.05). Five patients were unresponsive to HBVac. Relapse rates after the vaccination were higher than those in the prevaccination period (p=0.002). HBVac is less effective in producing immune response in SSNS children with steroid therapy. HBVac may trigger relapse in some patients. We recommend HBVac to SSNS children with low dose steroid therapy or after steroids are discontinued.

Effects of different bladder management methods on the quality of life in patients with traumatic spinal cord injury.

STUDY DESIGN: Multi-center, cross-sectional study. OBJECTIVES: To investigate the effects of different bladder management methods on the quality of life (QoL) in patients with spinal cord injury (SCI). SETTING: Turkey. METHODS: Consecutive SCI patients (n=195, 74.4% males), for whom at least 6 months had elapsed since the injury, were included and evaluated in five groups: normal spontaneous micturition (NSM), micturition with assisted maneuvers (MAM), aseptic intermittent catheterization by patient (IC-P), aseptic IC by an attendant/caregiver (IC-A) and indwelling catheterization. The King's Health Questionnaire was used to evaluate the patients' QoL. RESULTS: The bladder management groups were similar regarding age, time elapsed since injury, education level, marital and occupational status. There was no difference among the groups in general health perception, personal relationships and sleep/energy domain scores. While the NSM group had generally the lowest scores, that is, better QoL, the IC-A group had the highest scores, that is, poorer QoL, in most of the domains. When the patients were grouped according to the frequency of urinary incontinence or American Spinal Injury Association Impairment Scale grades, no difference was found in the domain scores of the groups except the symptom severity domain scores. No significant difference was found between paraplegic and tetraplegic patients in the King's Health Questionnaire domains. CONCLUSION: The QoL was notably affected in SCI patients in IC-A group and negative effects on emotional status, physical and social activity limitations were observed, as well.

Effects of small-diameter silver nanoparticles on microbial load in cow milk.

Controlling bacterial growth in fluid milk is of economic interest, and supplemental methods to stop or reduce bacterial growth before and during the cooling chain may be valuable. Silver is effective in controlling growth of single-celled organisms, but has no effect on tissue cells. Smaller diameter (6-8 nm) silver nanoparticles were produced, with purity over 99.99% (no chemical reaction used in the process), by using a terminated gas condensation principle. The first trial investigated effects of time, temperature, and accelerating voltages on total aerobic bacteria count in control milk and milk treated with silver nanoparticles. Metal braids were coated with silver nanoparticles using 3 accelerating voltages, 0, 100, and 200V, the results of which indicated that the braids coated using 100V (AgNP100) were optimal. The AgNP100 particles were effective at all treatment temperatures and durations except for 10h, which indicated that the treated milk could be used after 10h for other dairy products such as yogurt, which require microbial activity. The second experiment investigated the effects of silver nanoparticles on counts of yeasts and molds, coliform bacteria, Escherichia coli, and Staphylococcus aureus in cow milk by treating milk with AgNP100 braids at 22 °C for 1h. Inductively coupled plasma mass spectrometry analyses indicated that the maximum amount of silver found in the AgNP100-treated milk was 6.1µg/L, which is below the safety limits. Counts in milk samples containing the nanoparticle-coated braids were lower for all yeasts and molds and bacteria investigated compared with the control milk samples, which were kept under the same conditions but without the braids. The differences were significant for coliforms, Escherichia coli, and Staphylococcus aureus but not for yeasts and molds, although ranking of the counts (AgNP100 < initial load < control) were the same for all microorganisms. Small-diameter, silver nanoparticle-coated braids can stop or reduce bacterial growth in fluid milk. Silver nanoparticles inhibited microbial growth and may be useful in complementing the cooling chain and the thermal processes. These results warrant more research on the sensory properties and long-term safety of the use of silver nanoparticles in dairy products.

Henoch-Schönlein nephritis: a nationwide study.

BACKGROUND/AIM: The aim of this retrospective study was to evaluate the presentation, clinical and pathological manifestations and outcome of the Henoch-Schönlein purpura (HSP) nephritis in children. METHODS: Clinical and laboratory data of 443 children with HSP nephritis aged between 3 and 16 years from 16 pediatric nephrology reference centers were analyzed retrospectively. The biopsy findings were graded according to the classification developed by the International Study of Kidney Disease in Children (ISKDC). RESULTS: Renal biopsy was performed in 179 of the patients with HSP nephritis. The most common presenting clinical finding in patients who were biopsied was nephrotic range proteinuria (25%) which was followed by nephritic-nephrotic syndrome (23.5%). The biopsy findings according to the ISKDC were as follows: class I: 8.3%; II: 44.1%; III: 36.3%; IV: 6.7%; V: 3.3%; VI: 1.1%. All of the patients who developed end-stage renal disease had nephritic-nephrotic syndrome at presentation. Of 443 patients, 87.2% had a favorable outcome and 12.8% had an unfavorable outcome. The overall percentage of children who developed end-stage renal disease at follow-up was 1.1%. Logistic regression analysis did not show any association of initial symptoms and histology with outcome. CONCLUSION: In the presented cohort, the presence of crescents in the first biopsy or presenting clinical findings did not seem to predict the outcome of HSP nephritis in children. We conclude that children with HSP nephritis even with isolated microscopic hematuria and/or mild proteinuria should be followed closely.

A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics.

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.

Acute pseudogout arthritis in a patient with chronic renal failure: a case report.

Articular involvement such as osteodystrophy, osteonecrosis, dialysis-related amyloidosis, septic arthritis, malignancy and various crystal-induced arthropathies among patients with chronic renal failure is common. Cases of pseudogout (calcium pyrophosphate deposition disease) in patients with renal failure have been seen rarely in the literature. In these cases, acute pseudogout arthritis in only one joint such as an elbow, a wrist or an ankle in uremic patients has been reported. In our case, unlike the previously reported cases, pseudogout is found for the first time as the cause of arthritis which is concomitant in both knee and wrist joints in an uremic patient.

A combination of zinc and pyridoxine supplementation to the diet of laying hens improves performance and egg quality.

The objective of this study was to investigate whether zinc, along with pyridoxine, is effective in improving performance and egg quality of laying hens. One hundred and twenty, 28-week-old Hy-Line laying hens were assigned to four treatment groups, 30 hens each. The birds were fed a basal diet or the basal diet supplemented with either 30 mg of zinc/kg of diet, 8 mg of pyridoxine/kg of diet, or 30 mg of zinc plus 8 mg of pyridoxine/kg of diet. Feed conversion (P < 0.01) and egg production (P < 0.01) improved most when both zinc and pyridoxine were supplemented to the diet. Eggshell weights were also greatest (P < 0.01) when the diet was supplemented with both pyridoxine and zinc. Egg-shape index was, however, greatest with zinc-supplemented diet (P < 0.004). Haugh unit was greatest in eggs of hens fed a diet supplemented with both zinc and pyridoxine (P < 0.01). Dietary zinc and pyridoxine supplementations together increased plasma calcium and phosphorous concentrations (P < 0.002). The results of the present study suggested that zinc (30 ppm) and pyridoxine (8 ppm) supplements, when used together, are recommended in terms of a better performance and egg quality in laying hens.

Sympathetic skin responses from frontal region in migraine headache: a pilot study.

Frontal sympathetic skin responses (F-SSRs) were recorded to investigate sympathetic nervous system activity in migraine headache (MH). Thirty-five patients with unilateral MH and 10 healthy volunteers were studied by evoking bilateral F-SSRs with electrical stimulation of the median nerve in attack, post-attack and interictal periods. The mean latencies were longer and the maximum amplitudes were smaller on the symptomatic side compared with the asymptomatic side (P < 0.05 for both amplitude and latency) in attack and in interictal periods. In five patients, F-SSRs were absent bilaterally, in four patients the responses were absent only on the symptomatic side during the attack period. In the post-attack period, F-SSRs on the symptomatic side had higher amplitudes and shorter latencies compared with the asymptomatic side (P < 0.01 for both amplitude and latency). There is an asymmetric sympathetic hypofunction on the symptomatic side in attack and interictal periods, whereas there is a hyperfunction in the post-attack period.

Facial motor cortex plasticity in patients with unilateral peripheral facial paralysis.

Hand motor representation area expands towards the area of the perioral facial motor cortex in patients with peripheral facial paralysis (PFP) and in hemifacial spasm cases treated with botulinum toxin. In this current study, we aimed to investigate the changes both in the ipsilateral and contralateral facial motor cortex areas in patients with PFP with transcranial magnetic stimulation (TMS). Thirty healthy individuals and 41 patients with unilateral PFP with partial or total axonal degeneration participated in this study. Motor evoked potentials (MEPs) of perioral muscles elicited by TMS of the intracranial portion of the facial nerve and motor cortex, were recorded. TMS was delivered through a figure-of-eight coil. Mapping of the cortical representation of perioral muscles were also studied in 13 of 41 patients and in 10 of control subjects. Mean amplitude of the intact perioral MEPs elicited by the ipsilateral hemisphere TMS, was significantly higher in patients than the control subjects. There was also a mild enlargement of the mean cortical representation area of intact perioral muscles on both hemispheres though it was not significant. We have concluded that there was a cortical reorganization in the hemisphere contralateral to the paralytic side resulting in an increase at corticofugal output related to intact perioral muscles.