SUMMARY OBJECTIVE: Rectal cancer is an important cause of mortality and morbidity globally. The aim of this study was to investigate whether the log odds of positive nodes system is a better indicator than tumor node metastasis and lymph node ratio systems to determine rectum cancer prognosis, which is an important cause of mortality and morbidity globally. METHODS: This was a single-center retrospective cross-sectional study. Data were obtained from the medical records of patients with rectum adenocarcinoma followed at Gazi University Hospital. The clinicopathological data of 128 patients with rectum adenocarcinoma who underwent low anterior resection or abdominoperineal resection between January 2010 and December 2018 was retrospectively reviewed. Patients with rectum adenocarcinoma as the first and only primary diagnosis, which was confirmed by histopathological examination, than those who had undergone complete curative resection via low anterior resection or abdominoperineal resection were included. Those with familial adenomatous polyposis or Lynch syndrome, those under 18 years of age, with a synchronous tumor, peritoneal spread, or metastatic disease at the time of diagnosis, and those with <12 lymph nodes dissected from the resection material were excluded from the study. RESULTS: In multivariate analysis, age, perineural invasion, tumor node metastasis stage, lymph node ratio stage, and log odds of positive nodes stage were found to be independent prognostic factors (p<0.05). LODDS2 patients’ mortality rates were 9.495 times higher than LODDS0 patients [hazard ratio=9.495, (95%CI 4.155–21.694), p<0.001] while LNR2 stage patients’ mortality rates were 7.016 times higher than LNR0 stage patients [hazard ratio=7.016, (95%CI 3.123–15.765), p<0.001] and N2 stage patients had a 5.135 times higher risk of mortality than those who were in N0 stage [hazard ratio=5.135 (95%CI 2.451–10.756), p<0.001]. CONCLUSION: Log odds of positive nodes is a more valuable prognostic factor for rectal cancer patients than tumor node metastasis and lymph node ratio systems to determine rectum cancer prognosis.

Resumen Antecedentes: La incidencia de metástasis en ganglios linfáticos retropancreáticos en pacientes con cáncer gástrico no es despreciable. Objetivo: Determinar los factores de riesgo de metástasis en los ganglios linfáticos (GL) retropancreáticos e investigar su importancia clínica. Método: Se analizaron retrospectivamente los datos clínicos patológicos de 237 pacientes con cáncer gástrico entre junio de 2012 y junio de 2017. Resultados: Hubo 14 pacientes (5.9%) que presentaron metástasis de GL retropancreático. La mediana de supervivencia de los pacientes con y sin metástasis del GL retropancreático fue de 13.1 y 25.7 meses, respectivamente. Según el análisis univariado, se encontró que el tamaño tumoral ≥ 8 cm, Bormann tipo III/IV, tipo indiferenciado, presencia de invasión angiolinfática, profundidad de invasión (pT4), estadio N3 y metástasis GL No. 3, 7, 8, 9 y 12p se asociaba con metástasis de GL retropancreático. Según el análisis multivariante, se encontró que el tamaño tumoral ≥ 8 cm, Bormann tipo III/IV, tipo indiferenciado, pT4, estadio N3, metástasis de GL No. 9 y metástasis de GL No. 12p eran variables pronósticas independientes para la metástasis de GL retropancreático. Conclusiones: La metástasis del GL retropancreático es un factor de mal pronóstico para el cáncer gástrico. El tamaño del tumor ≥ 8 cm, el tipo III/IV de Bormann, el tumor indiferenciado, el estadio pT4, N3 y las metástasis de GL No. 9 y 12p son factores de riesgo de metástasis en los GL retropancreáticos.

Abstract Background: The incidence of retropancreatic lymph node metastasis in gastric cancer patients is not negligible. Objective: The aim of present study was to determine the risk factors for retropancreatic lymph node (LN) metastasis and to investigate its clinical significance. Patients and Methods: Clinical pathologic data of 237 patients with gastric cancer between June 2012 and June 2017 were analyzed retrospectively. Results: 14 patients (5.9%) had retropancreatic LN metastases. The median survival of patients with and without retropancreatic LN metastasis was 13.1 and 25.7 months. According to univariate analysis; tumor size ≥ 8 cm, Bormann type III/IV, undifferentiated type, presence of angiolymphatic invasion, depth of invasion (pT4), N3 stage, No. 3, No. 7, No. 8, No. 9, and No. 12p LN metastasis was found to be associated with retropancreatic LN metastasis. According to multivariate analysis; tumor size ≥ 8 cm, Bormann type III/IV, undifferentiated type, pT4, N3 stage, No. 9 LN metastasis, and No. 12p LN metastasis were found to be independent prognostic variables for retropancreatic LN metastasis. Conclusion: Retropancreatic LN metastasis is a poor prognostic factor for gastric cancer. Tumor size (≥ 8 cm), Bormann type III/IV, undifferentiated tumor, pT4, N3 stage, and No. 9 and No. 12p LN metastasis are risk factors for metastasis to retropancreatic lymph node.

RESUMO: Foram investigados os efeitos da mistura dietética de Agaricus bisporus ou talo ou tampa sobre o desempenho de crescimento, componentes da carcaça e alguns parâmetros de qualidade da carne, contagens de bactérias aeróbias mesofílicas e histomorfologia intestinal em frangos de corte. Duzentos e quarenta frangos de corte Ross 308 de um dia de idade foram divididos em quatro grupos experimentais com quatro repetições, cada um incluindo 15 aves. Galinhas alimentadas com dieta basal (C), mistura de cogumelos (MM, 10 g caule + 10 g cap / kg de dieta), caule de cogumelo (MS, 20 g / kg dieta) e cogumelo (MC, 20 g / kg dieta). A taxa de conversão alimentar (FCR) foi melhorada (P < 0.01) por MS dietético enquanto o consumo de ração (FI) diminuiu (P < 0.01) em todos os grupos de tratamento em comparação com o controle. No entanto, o ganho de peso corporal (BWG) foi diminuído (P < 0.01) pela inclusão de MC. Os grupos suplementados com cogumelos apresentaram maiores (P < 0.05) bactérias aeróbias mesofílicas no ceco. A inclusão de MS aumentou a proporção entre a largura das vilosidades e a profundidade da cripta no jejuno (P < 0.01) e o comprimento das vilosidades no íleo (P < 0.01) e jejuno (P < 0.05). MC aumentou (P < 0.01) a profundidade de cripta no jejuno. Não houve diferença estatística entre os grupos nos componentes da carcaça (P > 0.05). Os valores L * diminuíram (P < 0.01) na carne da coxa, mas aumentaram (P < 0.01) na carne de peito com a inclusão de cogumelos. Os valores de a* diminuíram (P < 0.01) e os valores de b* aumentaram (P < 0.05) em ambas as coxas e peitos pela adição de cogumelos à dieta. Os resultados obtidos indicaram que a farinha de colmo de A. bisporus com um nível de inclusão de 20 g / kg de dieta teve efeitos favoráveis no desempenho do crescimento com maior eficiência alimentar, melhorou a morfologia intestinal com maior comprimento de vilosidade e aumentou a qualidade da carne de frangos de corte.

ABSTRACT: Effects of dietary Agaricus bisporus mixture or stalk or cap on growth performance, carcass components and some meat quality parameters, mesophilic aerobic bacterial counts, and intestinal histomorphology in broiler chickens were investigated. Two hundred and forty one-day-old male Ross 308 broiler chickens were divided into 4 experimental groups with 4 replicates, each including 15 birds. Chickens were fed with basal diet (C), mushroom mixture (MM, 10 g stalk+10 g cap/kg diet), mushroom stalk (MS, 20 g/kg diet) and mushroom cap (MC, 20 g/kg diet). Feed conversion ratio (FCR) was improved (P < 0.01) by dietary MS while feed intake (FI) decreased (P < 0.01) in all treatment groups compared to control. However, body weight gain (BWG) was decreased (P < 0.01) by MC inclusion. Mushroom supplemented groups had higher (P < 0.05) mesophilic aerobic bacteria in the cecum. MS inclusion increased villus height to crypt depth ratio in the jejunum (P < 0.01) and villus height in the ileum (P < 0.01) and jejunum (P < 0.05). MC increased (P < 0.01) crypt depth in the jejunum. There were no statistical differences among groups for carcass components (P > 0.05). The L* values were decreased (P < 0.01) in thigh meat but increased (P < 0.01) in breast meat by mushroom inclusion. The a* values were decreased (P < 0.01) and b* values were increased (P < 0.05) in both thigh and breast meat with mushroom addition to diet. The obtained results indicated that A. bisporus stalk meal at an inclusion level of 20 g/kg of diet had favourable effects on growth performance with higher feed efficiency, improved intestinal morphology with higher villus height and increased meat quality of broiler chickens.

RESUMEN El objeto de este estudio fue investigar la cuenca Erzincan a través de información gravitacional. También está enfocado en revelar las discontinuidades en el área de estudio asi como las discontinuidades enterradas. Se exponen los filtros de determinación de límites y los análisis de la estructura de la información para obtener información clara. El método de continuación hacia arriba se aplicó en las anomalías gravitacionales en niveles de 0.25, 0.50, 0.75 y 1 km. A la información continuada hacia arriba se le aplicaron los filtros Total Horizontal de Derivadas (THD), Señal Analítica (AS), Ángulo Inclinado de Derivadas (Tilt), Ángulo Theta de Derivadas (Cos θ), y Ángulo Inclinado Hiperbólico de Derivadas (HTAD). Este proceso permitió revelar las discontinuidades en la región y los límites de la estructura geológica. Las derivadas de Ángulo Inclinado y Ángulo Theta produjeron los mejores resultados en cuanto a las derivadas aplicadas con base en filtros. La información obtenida se comparó con estudios de superficie geológica y se revisó la compatibilidad entre las formaciones. Se encontraron nuevas discontinuidades adicionales a las discontinuidades determinadas en las observaciones de superficie a la luz de los resultados obtenidos. La cuenca Erzincan se modeló en tres dimensiones con información gravitacional en el área de estudio. Como resultado de la modelación, se determinó que la cuenca Erzincan tiene un promedio de profundidad de 7 kms.

ABSTRACT Erzincan Basin was investigated using gravity data within the scope of this study. It is also aimed to reveal the discontinuities in the work area as well as the buried discontinuities. Boundary determination filters and analysis of the structure of the data and its connection are revealed and clear information is obtained. Gravity anomalies were applied with an upward continuation method for 0.25, 0.50, 0.75 and 1 km levels. Total Horizontal Derivative (THD) filter, Analytical Signal (AS) filter, Tilt Angle Derivative (Tilt) filter, Total Horizontal Derivative (THDR) filter, Theta Angle Derivative (Cos θ) filter, Hyperbolic Tilt Angle Derivative (HTAD) were applied to upward continued data. The discontinuities in the region and the boundaries of the geological structure were revealed. Tilt and Theta Angle derivatives yield the best results from the applied derivative based filters. The obtained data were compared with the existing surface geology and the compatibility between the formations was checked. New discontinuities were found in addition to the discontinuities determined from surface observations in the light of the obtained results. Erzincan Basin was modeled in three dimensions using gravity data of the study area. As a result of modeling, Erzincan Basin has been determined to have an average thickness of 7 km.

Abstract The present study aimed to examine the effects of solid-state fermentation (SSF) using selective A. niger strains on the amino acid, mineral, condensed tannin, and other chemical contents of olive leaves. The dried samples were divided into nonfermented (C) and fermented (F) olive leaves, and the latter were fermented by the following A. niger strains: ATCC® 9142™ (F1), ATCC® 200345™ (F2), ATCC® 52172™ (F3), and ATCC® 201572™ (F4), with three replicates for each treatment. Group F4 presented the best results, although all fermented groups generally presented higher performance than C. The total content of amino acids of the fermented olive leaves increased by 68–209% in comparison to that of C, while the cellulose content of the fermented olive leaves decreased by 7–25%. The ash, crude protein (CP), and ether extract (EE) contents increased after fermentation, but the crude fiber (CF) and nitrogen-free extract (NFE) contents decreased. The content of neutral detergent fiber (NDF) did not change, but acid detergent fiber (ADF) varied among the groups. The starch and sugar contents of all fermented groups except F1 also decreased compared to those of C. The mineral contents increased in all fermented groups, and the condensed tannin content varied according to the A. niger strain used. Thus, olive leaves fermented with different A. niger strains, especially F4, seem to have considerable potential as ruminant feed, as they are enriched with amino acids and minerals and have an improved chemical composition. However, these results should be supported and validated by animal experiments.

Resumen El presente estudio tuvo como objetivo examinar los efectos de fermentación en estado sólido (FES) usando cepas de A. niger selectiva en el aminoácido, mineral, taninos condensados, y otros contenidos químicos de hojas de olivo. Las muestras secas se dividen en no fermentada (C) y se fermentan (F) hojas de olivo, y el último se fermentaron por las siguientes cepas de A. niger: ATCC® 9142TM (F1), ATCC® 200345TM (F2), ATCC® 52172TM (F3) y ATCC® 201572 ™ (F4), con tres repeticiones cada uno. Grupo F4 presentó los mejores resultados, aunque todos los grupos fermentadas presentan generalmente un mayor rendimiento que C. El contenido total de aminoácidos en hojas de olivo fermentados aumentó y 68 a 209% en comparación con C, mientras que el contenido de celulosa de hojas de olivo fermentados Disminución de 7–25% . La ceniza, proteína bruta (CP) y el extracto de éter (EE) Aumento de contenidos después de la fermentación, pero la fibra bruta (FB) y extracto libre de nitrógeno (NFE) disminuyó. La fibra detergente neutra (NDF) no cambió pero la fibra detergente ácida (ADF) varió entre los grupos. El contenido de almidón y azúcar de todos los grupos fermentados, excepto F1, también disminuyó. El contenido mineral aumentó en todos los grupos fermentados y el contenido de tanino condensado de acuerdo con la cepa de A. niger utilizada. Por lo tanto, hojas de olivo fermentados con diferentes cepas de A. niger, especialmente F4, parecen tener una considerabl el potencial para la alimentación de los rumiantes, ya que están enriquecidas con minerales y amino ácidos, y presentar una composición química mejorada. Sin embargo, estos resultados deben ser apoyados y validados por experimentos con animales.

Resumo Fundamento: A caquexia cardíaca é um importante preditor de redução de sobrevida em pacientes com insuficiência cardíaca com fração de ejeção reduzida (ICFER). O objetivo deste estudo foi avaliar os níveis de adropina e irisina em pacientes com ICFER caquéticos e não caquéticos, assim como a relação entre os níveis dessas proteínas e os parâmetros clínicos e laboratoriais nesses pacientes. Objetivos: Os objetivos do presente estudo foram avaliar os níveis de adropina e irisina em indivíduos caquéticos e não caquéticos e as relações entre os níveis dessas proteínas e os parâmetros clínicos e laboratoriais em pacientes com ICFEN. Métodos: Os prontuários de pacientes atendidos no ambulatório de cardiologia para ICFER foram triados. Aqueles com ICFER caquéticos foram identificados e constituíram o grupo de estudo (n = 44; idade média, 65,4 ± 11,2 anos; 61,4% de homens). Aqueles com ICFER e sem perda de peso foram arrolados como grupo controle (n = 42; idade média, 61,0 ± 16,5 anos; 64,3% de homens). Os níveis séricos de adropina e irisina de todos os pacientes foram medidos. Considerou-se significativo um p-valor < 0,05. Resultados: Os níveis séricos de adropina e irisina foram significativamente mais altos nos pacientes caquéticos do que nos controles [adropina (ng/l): 286,1 (231,3-404,0) vs 213,7 (203,1-251,3); p < 0,001; irisina (µg/ml): 2,6 (2,2-4,4) vs 2,1 (1,8-2,4); p = 0,001]. Os níveis séricos de adropina e irisina correlacionaram-se positivamente com os níveis de peptídeo natriurético cerebral (BNP) e a classe funcional da New York Heart Association (NYHA), e negativamente com o índice de massa corporal (IMC) e os níveis séricos de albumina (todos os p-valores: < 0,001). Na análise multivariada, a adropina foi o único preditor independente de caquexia nos pacientes com ICFER (OR: 1,021; IC 95%: 1,004−1,038; p = 0,017). Conclusões: Os resultados sugerem que a adropina e a irisina possam ser novos marcadores de caquexia cardíaca em pacientes com ICFER. Adropina e irisina estão relacionadas com a gravidade da insuficiência cardíaca.

Abstract Background: Cardiac cachexia is an important predictive factor of the reduction in survival of patients with heart failure with reduced ejection fraction. Objectives: The aims of the present study were to evaluate adropin and irisin levels in cachectic and non-cachectic subjects and the relationships between the levels of these proteins and clinical and laboratory parameters in patients with HFrEF. Methods: The clinical records of patients who were admitted to the cardiology outpatient clinic for heart failure with reduced ejection fraction were screened. Cachectic patients were identified and assigned to the study group (n = 44, mean age, 65.4 ± 11.2 y; 61.4% men). Heart failure with reduced ejection fraction patients without weight loss were enrolled as the control group (n = 42, mean age, 61.0 ± 16.5 y; 64.3% men). The serum adropin and irisin levels of all patients were measured. A p-value < 0.05 was considered significant. Results: Serum adropin and irisin levels were significantly higher in the cachexia group than in the controls (Adropin (ng/L); 286.1 (231.3-404.0) vs 213.7 (203.1-251.3); p < 0.001, Irisin (µg/mL); 2.6 (2.2-4.4) vs 2.1 (1.8-2.4); p = 0.001). Serum adropin and irisin levels were positively correlated with brain natriuretic peptide (BNP) levels and New York Heart Association (NYHA) class and negatively correlated with body mass index (BMI) and serum albumin levels (all p values: < 0.001). In a multivariate analysis, adropin was the only independent predictor of cachexia in the heart failure with reduced ejection fraction patients (OR: 1.021; 95% CI: 1.004−1.038; p = 0.017). Conclusions: The results suggest that adropin and irisin may be novel markers of cardiac cachexia in heart failure with reduced ejection fraction patients. Adropin and irisin are related with the severity of heart failure.

ABSTRACT The objective of this study was to determine the effect of dietary symbiotic supplementation on the growth performance and duodenum histological parameters of quail reared in different flooring systems. A total of 160 mixed-sex healthy quail (47±0.32 g) aged 14 days were used in a 2 × 2 factorial experimental design with four replicates, each including five males and five females. Two flooring systems (wire floor as control and wood shavings bedding) and two dietary treatments (symbiotic supplementation and no supplementation) were tested. Birds were transferred to four-tier cages for the trial. Each kilogram of the commercial diet included 224 g crude protein and 3,080 kcal metabolizable energy. The experiment lasted 21 days. Daily weight gain and gastrointestinal tract weight were statistically higher in the wood shavings and wood shavings + symbiotic-supplemented groups than in control group. Villi length was higher in the wood shavings + symbiotic and symbiotic-supplemented groups than in control and wood shavings groups. The wood shavings groups had longer villi than control group. Villi width was higher in wood shaving + symbiotic-supplemented groups compared with the other treatment groups. The litter system of wood shavings and symbiotic supplementation provide better growth performance to quail by developing their duodenum histomorphological parameters and digestive tract.

Background. Thiamine-responsive megaloblastic anemia syndrome (TRMA), also known as Rogers syndrome, is characterized by megaloblastic anemia, sensorineural hearing loss, and diabetes mellitus. Disturbances of the thiamine transport into the cells results from homozygous or compound heterozygous mutations in the SLC19A2 gene. Case presentation. We report a girl which presented with sensorineural deafness treated with a hearing prosthesis, insulin requiring diabetes, macrocytic anemia, treated with thiamine (100 mg/day). Hemoglobin level improved to 12.1 g/dl after dose of thiamine therapy increased up to 200 mg/day. Conclusion. Patients with TRMA must be evaluated for megaloblastic anemia, sensorineural hearing loss, and diabetes mellitus. They must be followed for response of hematologic and diabetic after thiamine therapy. It should be kept in mind that dose of thiamine therapy may be increased according to the clinical response. Genetic counseling should be given.

Antecedentes. El síndrome de anemia megaloblástica sensible a la tiamina (TRMA, por sus siglas en inglés), también conocido como síndrome de Rogers, se caracteriza por presentar anemia megaloblástica, hipoacusia neurosensorial y diabetes mellitus. Las alteraciones en el transporte de la tiamina hacia las células se deben a mutaciones homocigotas o heterocigotas compuestas en el gen SLC19A2. Presentación de un caso. Presentamos el caso de una niña que manifestaba sordera neurosensorial tratada con una prótesis auditiva, diabetes con necesidad de insulina y anemia macrocítica, tratada con tiamina (100 mg/día). El nivel de hemoglobina mejoró hasta alcanzar 12,1 g/dl después de aumentar la dosis terapéutica de tiamina hasta 200 mg/día. Conclusión. Se debe evaluar a los pacientes con TRMA para detectar anemia megaloblástica, hipoacusia neurosensorial y diabetes mellitus. Se les debe dar seguimiento para determinar la respuesta de la enfermedad hematológica y de la diabetes después de la terapia con tiamina. La dosis terapéutica de tiamina puede aumentarse según la respuesta clínica. Debe proporcionarse asesoramiento genético.

OBJECTIVES: We investigated the relationship between metabolic syndrome and breast arterial calcification detected via mammography in a cohort of postmenopausal subjects. METHODS: Among 837 patients referred to our radiology department for mammographic screening, 310 postmenopausal females (105 patients with and 205 patients without breast arterial calcification) aged 40 to 73 (mean 55.9±8.4) years were included in this study. The groups were compared with respect to clinical characteristics and metabolic syndrome criteria. Univariate and multivariate analyses identified the factors related to breast arterial calcification. RESULTS: Age, postmenopausal duration and the frequencies of diabetes mellitus, hypertension and metabolic syndrome were significantly higher in the subjects with breast arterial calcification than in those without (p<0.05). Multivariate analysis indicated that age (OR = 1.3, 95% CI = 1.1-1.6, p = 0.001) and metabolic syndrome (OR = 4.0, 95% CI = 1.5−10.4, p = 0.005) were independent predictors of breast arterial calcification detected via mammography. The independent predictors among the features of metabolic syndrome were low levels of high-density lipoproteins (OR = 8.1, 95% CI = 1.0−64.0, p = 0.047) and high blood pressure (OR = 8.7, 95% CI = 1.5−49.7, p = 0.014). CONCLUSIONS: The likelihood of mammographic detection of breast arterial calcification increases with age and in the presence of hypertension or metabolic syndrome. For patients undergoing screening mammography who present with breast arterial calcification, the possibility of metabolic syndrome should be considered. These patients should be informed of their cardiovascular risk factors and counseled on appropriate lifestyle changes.

OBJECTIVES: Subclinical atherosclerosis has been recently detected in adolescents with a family history of premature atherosclerosis. However, no studies in the literature have assessed the cardiac autonomic functions of these adolescents. The aim of this study was to evaluate the cardiac autonomic functions of adolescents with a family history of premature atherosclerosis compared with those of age- and gender-matched adolescents without a family history of atherosclerosis. METHOD: We evaluated the cardiac autonomic functions of 36 adolescents with a family history of premature atherosclerosis (Group 1) and compared them with those of 31 age- and gender-matched adolescents whose parents did not have premature atherosclerosis (Group 2). Twenty-four-hour time domain (standard deviation of all normal sinus RR intervals [SDNN], standard deviation of the mean of normal RR intervals in each 5-minute segment [SDANN], root-mean-square differences in successive RR intervals) and frequency domain (very low frequency, low frequency, high frequency, low frequency/high frequency) parameters of heart rate variability were used for the evaluation of cardiac autonomic functions. RESULTS: There were no differences in the time and frequency domain parameters of heart rate variability between the two groups. Heart rate was negatively correlated with SDNN (r = -0.278, p = 0.035), while age was significantly correlated with root-mean-square differences in successive RR intervals, high frequency, low frequency and low frequency/high frequency (r = -0.264, -0.370, 0.265 and 0.374, respectively; p<0.05 for all). CONCLUSION: We found that the cardiac autonomic functions of adolescents with a family history of premature atherosclerosis were not different compared with those of adolescents without a positive family history of premature atherosclerosis. It appears that subclinical atherosclerosis does not reach a critical value such that it can alter cardiac autonomic functions in adolescence.

OBJECTIVE: Crimean-Congo hemorrhagic fever is an acute viral hemorrhagic fever with a high mortality rate. Despite increasing knowledge about hemorrhagic fever viruses, little is known about the pathogenesis of Crimean-Congo hemorrhagic fever. In this study, we measured serum adenosine deaminase and xanthine oxidase levels in Crimean-Congo hemorrhagic fever patients. METHODS: Serum adenosine deaminase levels were measured with a sensitive colorimetric method described by Giusti and xanthine oxidase levels by the method of Worthington in 30 consecutive hospitalized patients (mean age 42.6 ± 21.0). Laboratory tests confirmed their diagnoses of Crimean-Congo hemorrhagic fever. Thirty-five subjects (mean age 42.9 ± 19.1) served as the control group. RESULTS: There was a significant difference in adenosine deaminase and xanthine oxidase levels between cases and controls (p<0.05). However, neither adenosine deaminase nor xanthine oxidase levels varied with the severity of disease in the cases assessed (p>0.05). CONCLUSION: Adenosine deaminase and xanthine oxidase levels were increased in patients with Crimean-Congo hemorrhagic fever. Elevated serum xanthine oxidase activity in patients with Crimean-Congo hemorrhagic fever may be associated with reactive oxygen species generated by the xanthine/xanthine oxidase system during inflammatory responses. In addition, elevated lipid peroxidation may contribute to cell damage and hemorrhage. The association of cell damage and hemorrhage with xanthine oxidase activity should be further investigated in large-scale studies.