The clinical and laboratory findings of infants with atopic dermatitis during diagnosis and follow-up.

Summary: Background. Atopic dermatitis is a chronic disease that affects patient and parents life worsely. What time will the patient go into remission is not known. Therefore, clinical and laboratory indicators that can indicate remission are needed. Materials and Methods. The study was conducted in Izmir Health Sciences University, Tepecik Training and Research Hospital. The clinical and laboratory data of patients between January 2014 and December 2019 were scanned from the patient records and the hospital data system. Results. 102 patients with a median age of 8 (min 2- max 24) months were included in the study. The median age of onset of the symptoms was 3 (min 1-max 21) months. The patients most frequently (85.2%) presented with eczema and lesions were most common (60.7%) in the extremities. Most of the patients (56.9%) had mild dermatitis. In the 6th month, 26.5% who continued follow-up had clinical improvement. Food allergy was present in 33.3% of the patients. The most common food allergen was egg (52.9%). Food allergy was associated with the severity of atopic dermatitis (p = 0.033), and the symptoms started earlier (p = 0.002). There is no relationship between the severity of atopic dermatitis and gender, family history, presence of additional atopic disease, response to treatment, total IgE and eosinophil count (p > 0.05); however, it was determined that the symptoms started earlier in patients with moderate/severe atopic dermatitis (p = 0.002). Conclusions. Food allergy is more common in the early-onset and moderate/severe atopic dermatitis. Accurate diagnosis of food allergy is necessary to increase the success of treatment and to prevent unnecessary diets.

Investigation of time-dependent alterations in adipokine levels and endoplasmic reticulum stress markers in obese patients with laparoscopic sleeve gastrectomy.

BACKGROUND AND AIMS: We aimed to investigate the time-dependent alterations of serum, adipose tissue WISP1, Nrg4, asprosin, SPX adipokines and serum ER stress markers GRP78, XBP1, ATF6, CHOP in obese patients who underwent laparoscopic sleeve gastrectomy (LSG). MATERIALS AND METHODS: Morbidly obese patients (n = 19) and normal-weight individuals (n = 19) were compared. Preoperative (control, obese) and postoperative 1st, 3rd and 6th month (obese) follow-up measurements were obtained. Levels of adipokines, ER stress markers were measured with commercial kits. RESULTS: Body mass index (BMI), total fat, trunk fat mass, fat percentage of obese patients decreased after LSG. Postoperative serum glucose, insulin, HOMA-IR, triglyceride levels of obese patients decreased, HDL increased. In obese patients, preoperative LDL and total cholesterol, which were not different from control, were higher in the postoperative 6th month measurements. Omentum WISP1, subcutaneous adipose tissue WISP1 and SPX, and serum WISP1, asprosin, CHOP levels were higher, Nrg4 lower in obese patients. Serum Nrg4 was still lower in the postoperative 1st month measurements, while WISP1 was higher in the 3rd and asprosin in the 3rd, 6th months compared to control. 1st and 3rd month ATF6 and 3rd month CHOP concentrations were lower than preoperative values. Serum CHOP measured at the 6th month was significantly higher than control. Negative correlations were observed between serum Nrg4 and fat percentage, TG concentration. CHOP was negatively correlated with fat percentage. CONCLUSION: The correlations between changes in serum Nrg4, CHOP and fat percentage highlight the roles of Nrg4 and CHOP in the fat loss following LSG.

Factors effecting natural course of egg allergy.

Summary: Background. There is limited data about the natural course of egg allergy in the literature. We aimed to analyze the factors that can affect the tolerance or persistence of egg allergy. Methods. A total number of 126 IgE- mediated egg allergic patient who had data about tolerance gaining were included in the study. Demographic and laboratory data were recorded retrospectively. Kaplan-Meier curves was used for estimation of resolution and the factors related to resolution by Cox regression model. Results. Among 126 patients 81 (64.2%) had gained tolerance with a median survival time of 48 months (min 12- max 121). Tolerance was gained in 22.2% (28) of these patients in the first 2 years, in 46.8% (49) 2-6 years, 3.1% (4) between 7-12 years. In univariate analysis, no history of anaphylaxis (at initiation or during OFC) (Hazard ratio 2.193; 95%CI 1.309-3.674, p = 0.003), baseline sIgE level less than 8.2 (Hazard ratio 11.292; 95%CI 2.766-46.090, p = 0.001) and baseline egg SPT less than 11 mm (Hazard ratio 2.906; 95%CI 1.424-5.930, p = 0.003) were found to be related to earlier resolution of egg allergy. In multivariate analysis only anaphylaxis was significantly related to later resolution (Hazard ratio: 6.547; 95%CI 15.80-27.434, p = 0.01). Conclusions. Higher levels of egg sIgE, skin prick test induration and anaphylaxis at onset or during oral food challenge, can give hint about persistence of egg allergy.

Correlación entre la captación de 18F-FDG del tumor primario con los factores pronósticos y subtipo molecular del cáncer ductal de mama / Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer

Objetivos: En este estudio nos propusimos investigar la correlación entre el SUVmáx del tumor primario y los factores de pronóstico/subtipo molecular en pacientes con cáncer de mama ductal.Materiales y métodos: Revisamos retrospectivamente a 150 pacientes mujeres con cáncer de mama ductal invasivo patológicamente comprobado desde enero de 2015 hasta octubre de 2019 que se sometieron a una PET/TC con 18F-FDG para la estadificación inicial. Las características pronósticas histopatológicas del tumor primario (grado histológico, estado de los receptores hormonales, índice Ki-67) se obtuvieron del informe de la biopsia tru-cut. En los estudios PET/TC con 18F-FDG se calculó el valor máximo de captación estandarizada (SUVmáx) del tumor primario de mama y se comparó con la presencia de linfadenopatía axilar y/o metástasis a distancia, factores pronósticos histopatológicos y subtipo molecular.Resultados: El alto SUVmáx de los tumores de mama primarios está significativamente correlacionado con los factores clínico-patológicos: gran tamaño del tumor, alto grado histológico, alto índice Ki-67, positividad de los ganglios linfáticos axilares y metástasis a distancia. El valor SUVmáx fue significativamente más alto en los pacientes con subtipo basal que en los pacientes con subtipo luminal A (8,14 ± 3,71 y 4,64 ± 2,45, p = 0,002). El análisis de correlación reveló una baja correlación entre el índice Ki-67 y el SUVmáx (r = 0,276, p = 0,001) y una correlación moderada entre el tamaño del tumor y el SUVmáx (r = 0,470, p = 0,001). En el análisis de regresión multivariante de líneas el índice Ki-67 y el tamaño del tumor tuvieron un efecto estadísticamente significativo en los valores del SUVmáx. A medida que estos parámetros aumentan se observa un incremento de los valores SUVmáx (p = 0,004, Std Beta: 0,228, IC 95%: 0,010-0,055 y p = 0,001, Std Beta: 0,374, IC 95%: 0,55-0,136, respectivamente).Conclusión: El alto valor SUVmáx se asocia con factores pronósticosmal

Objectives: In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients.Materials and methods: We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype.Results: The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8.14 ± 3.71 and 4.64 ± 2.45, p = 0.002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r = 0.276, p = 0.001) and moderate correlation between tumor size and SUVmax (r = 0.470, p = 0.001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p = 0.004, Std Beta: 0.228, 95% CI: 0.010–0.055 and p = 0.001, Std Beta: 0.374, 95% CI: 0.55–0.136, respectively).Conclusión: High SUVmax value is associated with prognotic factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer (AU)

Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer.

OBJECTIVES: In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients. MATERIALS AND METHODS: We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype. RESULTS: The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8.14±3.71 and 4.64±2.45, p=0.002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r=0.276, p=0.001) and moderate correlation between tumor size and SUVmax (r=0.470, p=0.001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p=0.004, Std Beta: 0.228, 95% CI: 0.010-0.055 and p=0.001, Std Beta: 0.374, 95% CI: 0.55-0.136, respectively). CONCLUSION: High SUVmax value is associated with prognotic factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.

Increased Expression of Pentraxin 3 in Placental Tissues from Patients with Unexplained Recurrent Pregnancy Loss.

Pentraxin 3 (PTX3), a prototypical member of the long pentraxin subfamily, is a evolutionarily conserved multimeric pattern recognition receptor involved in the humoral component of the innate immune system. Pentraxin 3 is released when tissue is stressed or damaged, and interacts with many different ligands. Pentraxin 3 exerts a pivotal role both as a regulator and as an indicator of inflammatory response in the pathogenesis of many diseases such as sepsis, vasculitis and preeclampsia. Uncontrolled inflammatory response is considered a major cause of unexplained recurrent pregnancy loss (URPL). We determined the PTX3 messenger ribonucleic acid (mRNA) and protein expression levels in placentai tissues from 50 women with URPL, and made comparison with those in 50 age-matched control subjects. In quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry analyses, PTX3 mRNA and protein levels, respectively, were significantly increased in URPL patients compared with their respective controls (p = 0.0001). Although no significant correlations were identified between PTX3 expression levels and clinical parameters such as maternal age, numbers of previous pregnancy losses, and gestational age at miscarriage, PTX3 mRNA expression was significantly higher in patients with no live births than in women with previous live births (p = 0.0001). Our study suggests that tissue-specific expression of PTX3 is associated with URPL. Further larger studies are required to determine whether PTX3 expression can be used as a biomarker to manage URPL in routine clinical practice.

Dabigatran Versus Warfarin in Atrial Fibrillation: Multicenter Experience in Turkey.

Safety issues have been raised about dabigatran. We aimed to investigate the occurrence of safety outcomes in patients who had atrial fibrillation and a risk of stroke. We analyzed 439 patients prescribed dabigatran (n = 220) or warfarin (n = 219). Ischemic stroke occurred in 15 (6.8%) patients in the warfarin group versus 5 (5.2%) patients in the 110-mg group versus 1 (0.8%) patient in the 150-mg dabigatran group (P = .015). Intracranial hemorrhage occurred in 6 (2.7%) patients in the warfarin group versus 3 (2.4%) patients in the 150-mg dabigatran group (P = .104). Death from any cause occurred in 10 (4.6%) patients in the warfarin group versus 1 (1.0%) patient in the 110-mg dabigatran group (P = .005). Dabigatran was associated with less ischemic stroke and death from any cause than warfarin. Dabigatran may be a better option for stroke prophylaxis, where recommended monitoring with warfarin is suboptimal.

Investigation of the association between the outcomes of sperm chromatin condensation and decondensation tests, and assisted reproduction techniques.

The main purpose of this prospective study is to examine possible influences of abnormalities of sperm nuclear condensation and chromatin decondensation with sodium dodecyl sulphate (SDS)-EDTA on outcomes of intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) cycles. Semen samples from 122 IUI and 236 ICSI cycles were evaluated. Before semen preparation for IUI or ICSI, basic semen analysis was performed and a small portion from each sample was spared for fixation. The condensation of sperm nuclear chromatin was evaluated with acidic aniline blue, followed by sperm chromatin decondensation by SDS-EDTA and evaluation under light microscope. Ongoing pregnancy rate was 24% and 26.2% in the IUI and ICSI groups respectively. The chromatin condensation rate was significantly higher in the ongoing pregnancy-positive group compared to the negative group, both in IUI (P = 0.042) and ICSI groups (P = 0.027), and it was positively correlated with ongoing pregnancy rate in both IUI and ICSI groups (P = 0.015, r = 0.214 and P = 0.014, r = 0.312 respectively). Chromatin decondensation rates were not significantly different in neither of the groups. These results indicate that IUI and ICSI outcome is influenced by the rate of spermatozoa with abnormal chromatin condensation. Sperm chromatin condensation with aniline blue is useful for selecting assisted reproduction techniques (ART) patients.

Assessment of human sperm morphology by strict criteria: comparison of wet preparation versus stained with the modified Diff-Quik method.

Routine semen examination remains an important tool for the diagnosis and treatment in human subfertility. Of all semen parameters, sperm morphology seems to be one of the most powerful indicators of a man's fertilizing potential in vitro and in vivo. Lack of standardization of sperm morphology assessments remains the main reason for the usefulness of this parameter. The aim of this study was to analyze the agreement between the wet-stained preparations versus those stained with modified Diff-Quik for sperm morphology. A total of 100 unselected semen samples from infertile couples were analyzed. Sperm morphology was evaluated with unstained specimens and following modified Diff-Quik staining according to the strict (Kruger classification) criteria by two different examiners (intralaboratory blind assessment). Mean percentages of morphologically normal spermatozoa were identical on wet and stained preparation slides (4.79 vs. 4.61, p >.05). Wide divergence of results was found with respect to the percentage of sperm with head and midpiece defects with the two different preparations (p >.001). The percentage of sperm tail defects was similar in both methods (p >.05). Simple linear regression analysis between the two methods revealed very good correlation for the morphologically normal spermatozoa (r =.83), but poor correlation for the sperm head, midpiece, and tail defects (r =.25,.25, and.28, respectively). Wet preparation is suitable only for the morphologically normal spermatozoa, but to determine the percentage of the defective spermatozoa, staining the smear is recommended.

Effects of indoleamines on sperm motility in vitro.

Indoleamines are products of the pineal gland and are postulated to play an antigonadotrophic role in the reproductive system of mammals. In humans, indoleamines have been localized in tissue fluids such as plasma, serum and cerebrospinal fluid. Because indoleamines exhibit antigonadotrophic properties, the authors examined whether these agents cause inhibitory effects on sperm motility. In this study, time and dose-dependent inhibition of sperm motility by indoleamines was observed. Furthermore, the presence of indoles in incubation medium decreased sperm velocity. These data suggest that the presence of high doses of indoles in reproductive fluids may inhibit sperm motility and velocity.