SUMMARY OBJECTIVE: The purpose of this study was to evaluate monocyte count and high-density lipoprotein cholesterol levels and their ratio (monocyte/high-density lipoprotein ratio) in patients with deep venous thrombosis as well as to determine whether this ratio at the time of diagnosis can be an indicator of thrombus burden in terms of thrombus location in deep venous thrombosis. METHODS: We retrospectively analyzed the patient's diagnosis of deep venous thrombosis confirmed with venous Doppler ultrasound, using a database query for outpatients between 2018 and 2022. Of 378 patients included, blood count results at the time of diagnosis were available for 356. We recruited 300 age- and sex-matched patients with appropriate blood counts, without a diagnosis of deep venous thrombosis, as the control group, by querying the outpatient clinic database. The monocyte/high-density lipoprotein ratio was computed from the ratio of monocyte count to high-density lipoprotein-C. Patients were categorized based on the level of thrombus and the number of vein segments involved as evidenced by Doppler ultrasound findings. RESULTS: The serum level of monocyte/high-density lipoprotein ratio was significantly higher in the patient group compared to the control group (p<0.01). Patients with proximal deep venous thrombosis had a higher mean monocyte/high-density lipoprotein ratio (19.6±5.1 vs. 17.1±5.5; p<0.01) than patients with distal deep venous thrombosis. Monocyte/high-density lipoprotein ratio increased with the number of vein segments involved (p<0.01). CONCLUSION: Monocyte/high-density lipoprotein ratio is significantly elevated in patients with deep venous thrombosis when compared to the control group. Monocyte/high-density lipoprotein ratio levels were correlated with disease burden reflected by thrombus location and the number of vein segments involved in deep venous thrombosis patients.

Abstract The current research was conducted to determine the deoxynivalenol (DON) and ochratoxin A (OTA) levels of 24 pieces of wheat flour, 24 pieces of rice, 24 pieces of corn flour, and 24 pieces of whole wheat flour obtained from the markets in Istanbul by HPLC. DON was detected in 4 of the 96 grain cereal samples at levels between 0.94 and 1.16 µg/kg (LOQ, 0.92 µg/kg). Besides, from the analyzed samples, DON was detected in 3 pieces of ashura wheat, 2 pieces of rice, and 5 pieces of corn flour between LOD and LOQ. The highest DON level was found in the corn flour sample (1.16 µg/kg), which was sold unpacked. OTA was detected in 11 of the samples (0.87-6.97 µg/kg) consisting of 3 corn flours (1.51-2.23 µg/kg) and 8 whole wheat flours (0.87-6.97 µg/kg). The highest OTA level was found in the packaged whole wheat flour sample (6.97 µg/kg) bought from the market. Since DON and OTA exposure can be observed frequently in cereals and may increase to possible risky levels, further work should be done to determine the precautions necessary to minimize the risks of contamination.

ABSTRACT Objective: Evaluation of left ventricular systolic function using speckle tracking echocardiography is more sensitive than conventional echocardiographic measurement in detecting subtle left ventricular dysfunction in septic patients. Our purpose was to investigate the predictive significance of left ventricular global longitudinal strain in normotensive septic intensive care patients. Methods: This observational, prospective cohort study included septic normotensive adults admitted to the intensive care unit between June 1, 2021, and August 31, 2021. Left ventricular systolic function was measured using speckle-tracking echocardiography within 24 hours of admission. Results: One hundred fifty-two patients were enrolled. The intensive care unit mortality rate was 27%. Left ventricular global longitudinal strain was less negative, which indicated worse left ventricular function in non-survivors than survivors (median [interquartile range], -15.2 [-17.2 - -12.5] versus -17.3 [-18.8 - -15.5]; p < 0.001). The optimal cutoff value for left ventricular global longitudinal strain was -17% in predicting intensive care unit mortality (area under the curve, 0.728). Patients with left ventricular global longitudinal strain > -17% (less negative than -17%, which indicated worse left ventricular function) showed a significantly higher mortality rate (39.2% versus 13.7%; p < 0.001). According to multivariate analysis, left ventricular global longitudinal strain was an independent predictor of intensive care unit mortality [OR (95%CI), 1.326 (1.038 - 1.693); p = 0.024], along with invasive mechanical ventilation and Glasgow coma scale, APACHE II, and SOFA risk scores. Conclusion: Impaired left ventricular global longitudinal strain is associated with mortality and provided predictive data in normotensive septic intensive care patients.

RESUMO Objetivo: A avaliação da função sistólica do ventrículo esquerdo utilizando ecocardiografia com speckle tracking é mais sensível do que a medição ecocardiográfica convencional na detecção de disfunções sutis do ventrículo esquerdo em pacientes sépticos. Nosso objetivo foi investigar a significância preditora do strain longitudinal global do ventrículo esquerdo em pacientes sépticos normotensos internados em unidades de terapia intensiva. Métodos: Este estudo de coorte observacional e prospectivo incluiu adultos sépticos normotensos internados em uma unidade de terapia intensiva entre 1° de junho de 2021 e 31 de agosto de 2021. A função sistólica do ventrículo esquerdo foi mensurada utilizando a ecocardiografia com speckle tracking nas primeiras 24 horas após a internação. Resultados: Foram recrutados 152 pacientes. A taxa de mortalidade na unidade de terapia intensiva foi de 27%. O strain longitudinal global do ventrículo esquerdo foi menos negativo, o que indicou pior função do ventrículo esquerdo em não sobreviventes do que em sobreviventes (mediana [intervalo interquartil] -15,2 [-17,2 - -12,5] versus -17,3 [-18,8 - -15,5]; p < 0,001). O valor de corte ótimo para o strain longitudinal global do ventrículo esquerdo foi -17% para prever a mortalidade na unidade de terapia intensiva (área sob a curva de 0,728). Pacientes com strain longitudinal global do ventrículo esquerdo > -17% (menos negativo do que -17%, o que indicou pior função do ventrículo esquerdo) apresentaram taxa de mortalidade significativamente maior (39,2% versus 13,7%; p < 0,001). De acordo com a análise multivariada, o strain longitudinal global do ventrículo esquerdo foi um preditor independente de mortalidade na unidade de terapia intensiva [RC (IC95%), 1,326 (1,038 - 1,693); p = 0,024], com ventilação mecânica invasiva e os escores de risco da escala de coma de Glasgow, APACHE II e SOFA. Conclusão: Alterações do strain longitudinal global do ventrículo esquerdo estão associadas a mortalidade e podem fornecer dados preditivos em pacientes sépticos normotensos internados em unidades de terapia intensiva.

SUMMARY OBJECTIVE: Chronic kidney disease (CKD) remains one of the major common health problems, and the number of people affected by the disease is progressively increasing in Turkey and worldwide. This study aimed to investigate molecular defects in Alport syndrome (AS) and other genes in patients with clinically suspected CKD using whole-exome sequencing (WES). METHODS: Patients with clinical suspicion of CKD were included in the study. Molecular genetic analyses were performed on genomic DNA by using WES. RESULTS: A total of 15 with 5 different pathogenic or likely pathogenic variants were identified in CKD patients, with a diagnostic rate of 30%. Eight variants of uncertain significance were also detected. In this study, 10 variants were described for the first time. As a result, we detected variants associated with CKD in our study population and found AS as the most common CKD after other related kidney diseases. CONCLUSIONS: Our results suggest that in heterogeneous diseases such as CKD, WES analysis enables accurate identification of underlying molecular defects promptly. Although CKD accounts for 10–14% of all renal dysfunction, molecular genetic diagnosis is necessary for optimal long-term treatment, prognosis, and effective genetic counseling.

RESUMO Objetivo: Avaliar, depois de 30 meses, a função visual e as alterações na espessura macular central de pacientes com degeneração macular relacionada à idade sem resposta terapêutica ao ranibizumabe (Lucentis®) que mudaram seu tratamento para o aflibercepte (Eylea®). Métodos: Realizou-se um estudo retrospectivo de pacientes com degeneração macular neovascular relacionada à idade que mudaram o tratamento para o aflibercepte após 6 ou mais injeções intravítreas de ranibizumabe a intervalos de 4-8 semanas. Todos os pacientes mudaram para o aflibercepte intravítreo (2,0 mg) e depois de 3 injeções consecutivas, seguidas de um regime de dosagem pro re nata, foram avaliados após 30 meses de tratamento. A melhor acuidade visual corrigida, o exame biomicroscópico, a pressão intraocular, a fundoscopia e a espessura macular central foram registrados no início do tratamento, antes da transição para o tratamento com aflibercepte intravítreo e aos 6, 12, 18, 24 e 30 meses de tratamento com o aflibercepte intravítreo. Resultados: Satisfizeram aos critérios de inclusão 33 olhos. A mediana da idade dos pacientes foi de 73,57 ± 7,98 anos. Dos pacientes, 21 (61,8%) eram homens e 12 (35,3%) eram mulheres. Antes da transição para o tratamento com o aflibercepte intravítreo, os pacientes receberam em média 16,8 ± 8,8 injeções de ranibizumabe (faixa 6-38).Depois da transição, o número médio de injeções de aflibercepte foi de 9,09 ± 3,94. Não houve diferenças significativas na melhor acuidade visual corrigida depois da mudança para o aflibercepte em qualquer das avaliações. Houve diminuição significativa da espessura macular central aos 6, 12, 18 e 30 meses (respectivamente, p=0,01, p=0,03, p=0,05, p=0,05 e p<0,001). Conclusão: Pacientes com degeneração macular neovascular relacionada à idade que mudaram seu tratamento para o aflibercepte intravítreo devido à falta de resposta ao ranibizumabe intravítreo, tiveram melhora anatômica significativa da retina; mas embora esse estado tenha persistido, não foi observado nenhum ganho funcional significativo.

ABSTRACT Purpose: This study was conducted to evaluate visual function and changes in the central macular thickness of patients with unresponsive neovascular age-related macular degeneration who were switched from ranibizumab (Lucentis®) to aflibercept (Eylea®) treatment at 30 months. Methods: This retrospective study examined patients with neovascular age-related macular degeneration who were switched to aflibercept after ≥6 previous intravitreal ranibizumab injections at 4- to 8-week intervals. All patients were switched to intravitreal aflibercept (2.0 mg) and analyzed after 3 consecutive injections followed by a prore nata dosing regimen and after 30 months of treatment. Best corrected visual acuity, biomicroscopic examination, intraocular pressure, fundus examination, and central macular thickness were recorded at the start of treatment, before the transition to intravitreal aflibercept treatment, and at 6, 12, 18, 24, and 30 months of intravitreal aflibercept treatment. Results: A total of 33 eyes met the inclusion criteria. The median age of the patients was 73.57 ± 7.98 years, and 21 (61.8%) patients were males and 12 (35.3%) were females. Before the transition, the patients received a mean of 16.8 ± 8.8 ranibizumab injections (range 6-38).After the transition to intravitreal aflibercept treatment, the mean number of aflibercept injections was 9.09 ± 3.94. No significant differences were observed in best corrected visual acuity after the aflibercept switch in any of the months. The central macular thickness was significantly decreased at 6, 12, 18, and 30 months (p=0.01, p=0.03, p=0.05, p=0.05, p<0.001, respectively). Conclusion: Patients with neovascular age-related macular degeneration who were switched to intravitreal aflibercept treatment due to unresponsiveness to intravitreal ranibizumab exhibited a significant anatomic improvement in the retina, and although this state persisted, there was no significant functional gain.

RESUMO: O setor agrícola, que ganhou importância com a Indústria 4.0 nos últimos anos, esforça-se por se adaptar às necessidades e exigências da época retirando sua estrutura tradicional. Nesse processo é importante aumentar a motivação do fator recursos humanos, que é o insumo mais importante da agricultura, em inovação, criatividade e empreendedorismo. Com este estudo, tentou-se revelar os fatores que afetam a motivação dos gerentes de empresas agrícolas na província de Kirsehir, na Turquia, sobre inovação e criatividade, que é uma das principais variáveis de crescimento. Os formulários do questionário foram preenchidos com 312 gerentes de empresas agrícolas, selecionados de acordo com o Método de Amostragem por Probabilidade. Os escores de motivação intrínseca para a criatividade (IMC) foram obtidos usando a escala de cinco pontos. Determinou-se que algumas variáveis sociodemográficas, agrícolas, econômicas e comportamentais para explorações agrícolas foram testadas com os níveis de IMC. Como resultado do estudo, foi determinado que variáveis como educação, status de seguridade social, parcela da renda agrícola, pobreza subjetiva e comportamentos de risco afetam significativamente o nível de IMC dos gerentes de empresas agrícolas. Como resultado, são necessárias medidas para aumentar as motivações internas e externas dos gerentes de empresas agrícolas, a fim de tornar a agricultura mais competitiva, rentável e sustentável, removendo-a da estrutura tradicional. Nesse sentido, não apenas o lado econômico, mas também o lado social da agricultura não devem ser ignorados e o potencial da agricultura deve ser mais utilizado nas reformas estruturais.

ABSTRACT: The agriculture sector which has gained importance with Industry 4.0 in recent years, strives to adapt to the needs and requirements of the era by stripping from its traditional structure. In this process, it is important to increase the motivation (intrinsic and extrinsic) of human resources factor, which is the most important input of agriculture, on innovation, creativity and entrepreneurship. This paper examined the factors that affect the intrinsic motivation of the agricultural holdings managers in Kirsehir province of Turkey on their creativity for innovation, which is one of the main variables of growth. Questionnaire forms were filled with 312 agricultural holdings managers who were selected according to the Probability Sampling Method in September-October, 2019. Intrinsic motivation scores for creativity (IMC) were obtained by using 5-point scale. Determined some socio-demographical, agricultural, economic and behavioral variables for agricultural holdings were tested with IMC levels. As a result of the study, it was determined that variables such as education, social security status, share of agricultural income, subjective poverty and risk behaviors significantly affect the IMC level of the agricultural enterprise managers. As a result, the measures to increase both the internal and external motivations of the agricultural enterprises managers are required in order to make agriculture more competitive, profitable and sustainable by removing it from the traditional structure. In this regard, not only the economic side but also the social side of agriculture should not be ignored and the potential of agriculture should be used more with structural reforms.

Abstract Objective This study aims to evaluate the effect of ellagic acid (EA) by measuring the levels of alveolar bone resorption and inflammatory and oxidative stress markers in the periodontal tissues and serum on the periodontal repair process related to experimental periodontitis in rats. Methodology Forty Wistar rats were divided into four study groups as follows: Group 1=healthy control (n=10); Group 2=EA control (15 mg/kg)(n=10); Group 3=periodontitis (n=10); Group 4=periodontitis+EA (15 mg/kg) (n=10). The periodontitis model was established by ligating bilateral mandibular first molars for 14 days. Then, rats were given normal saline or EA for another 14 days by gavage administration. Serum and gingiva myeloperoxidase (MPO) activity, 8-hydroxydeoxyguanosine(8-OHdG), and glutathione (GSH) levels were analyzed by ELISA. İmmunohistochemical analysis was used to detect Interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α) immunoreactivities in the periodontal tissues. Alveolar bone loss (ABL) and attachment loss (AL) was evaluated by histomorphometry analysis. Results ABL and AL were statistically higher in group 3 than in groups 1, 2 and 4 and in group 4 than in groups 1 and 2 (p<0.05). MPO activities in gingival tissue and serum were significantly increased in group 3 compared to groups 1 and 2 (p<0.05). Significantly higher serum GSH levels, lower gingiva, and serum 8-OHdG levels, and MPO activity were observed in group 4 compared to group 3 (p<0.05). Rats with periodontitis (group 3) expressed significantly higher immunoreactivities of IL-6 and TNF-α and lower IL-10 immunoreactivity compared to those other groups (p<0.05). IL-6 and TNF-α immunoreactivities significantly decreased and IL-10 immunoreactivity increased in group 4 after the use of EA compared to group 3 (p<0.001). Conclusions Our findings showed that EA provides significant improvements on gingival oxidative stress and inflammatory markers and alveolar bone resorption in the repair process associated with experimental periodontitis. Therefore, EA may have a therapeutic potential on periodontitis.

Resumo Introdução O carcinoma de células escamosas é a neoplasia laríngea mais comum, representa aproximadamente 95% de todas as neoplasias malignas da laringe. No entanto, vários outros tumores benignos e malignos, e doenças inflamatórias, podem afetar a laringe. Objetivo O objetivo deste estudo é analisar os achados clínicos e de imagem de neoplasias de células não-escamosas e de doenças inflamatórias da laringe. Método Este estudo retrospectivo foi feito com 18 pacientes diagnosticados com lesões de carcinoma de células não escamosas da laringe em nossa instituição, entre 2007-2017. Foram analisados os sintomas clínicos, achados dos exames, características de imagens, diagnóstico histopatológico e modalidades de tratamento. Resultados Foram identificados 9 casos com lesão maligna (2 condrossarcomas, 1 tumor carcinoide neuroendócrino atípico, 1 linfoma de células T/NK, 1 linfoma difuso de grandes células B, 3 plasmocitomas com envolvimento de mieloma múltiplo, 1 metástase de adenocarcinoma, 3 neoplasias benignas (condroma, paraganglioma, lipoma), 2 lesões tumor like (tumor de Brown e tumor miofibroblástico inflamatório), 3 lesões inflamatórias (granulomatose de Wegener, doença de Behçet e tuberculose) e 1 malformação vascular. O sintoma mais comum foi a rouquidão (66,6%). O paraganglioma foi visto como lesão hipervascular na tomografia computadorizada e na ressonância magnética e mostrou intensa captação do traçador na PET/TC com 68Gálio-DOTA. Calcificações de matriz condroide foram detectadas no condroma e condrossarcoma grau 1. Em pacientes com malformação vascular e lipoma, os achados típicos de imagem tornaram possível o diagnóstico. Conclusão Estudos de imagem podem fornecer pistas para o diagnóstico de lesões laríngeas de células não escamosas. Achados clínicos e de imagem e histórico clínico prévio devem ser avaliados em conjunto no manejo clínico das lesões laríngeas.

Abstract Introduction Squamous cell carcinoma is the most common laryngeal neoplasm and accounts for approximately 95% of all malignant neoplams of the larynx. However, various benign and malignant tumors and inflammatory diseases may affect the larynx. Objective The purpose of this study is to analyze the clinical and imaging findings of non-squamous cell neoplasms and inflammatory diseases of the larynx. Methods This retrospective study was conducted in 18 patients who were diagnosed with non-squamous cell carcinoma lesions of larynx at our institution between 2007-2017. Clinical symptoms, examination findings, imaging characteristics, histopathologic diagnosis and treatment modalities were analyzed. Results There were 9 malignant lesions (2 chondrosarcoma, 1 neuroendocrine tumor-atipical carcinoid, 1 Natural Killer/T-cell lymphoma, 1 diffuse large B-cell lymphoma, 3 plasmocytoma-multiple myeloma involvement, 1 adenocarcinoma metastasis), 3 benign neoplasms (chondroma, paraganglioma, lipoma), 2 tumor-like lesions (Brown tumor and inflammatory myofibroblastic tumor), 3 inflammatory lesions (Wegener granulomatosis, Behçet's disease and tuberculosis involvements), and 1 vascular malformation. The most common presenting symptom was hoarseness (66.6%). Paraganglioma was seen as hypervascular lesion on computed tomography and magnetic resonance imaging and showed intense tracer uptake on 68Gallium-DOTA-peptide PET/CT. Chondroid matrix calcifications were detected in chondroma and chondrosarcoma-grade 1. In patients with vascular malformation and lipoma, the typical imaging findings made it possible to diagnose. Conclusion Imaging studies may provide clues for diagnosis of non-squamous cell laryngeal lesions. Clinical and imaging findings and previous clinical history should be evaluated together in clinical management of laryngeal lesions.

RESUMO Este estudo descreve os efeitos terapêuticos e os resultados de uma injeção acidental de implante intralenticular de dexametasona de liberação sustentada (Ozurdex®) em três pacientes com edema macular diabético. Todos os três pacientes foram submetidos a injeções acidentais de implantes intravítreos de dexametasona de liberação sustentada na lente do cristalino pelo mesmo cirurgião. Após a injeção acidental de Ozurdex® na lente do cristalino, observou-se uma redução notável no edema macular e uma melhora na acuidade visual, sugerindo que um resultado positivo pode ser alcançado sem cirurgia imediata.

ABSTRACT This report describes the therapeutic effects and outcomes of an accidental injection of an intralenticular sustained-release dexamethasone implant (Ozurdex®) in three patients with diabetic macular edema. All three patients underwent accidental injections of sustained-release intravitreal dexamethasone implants into the crystalline lens by the same surgeon. After the accidental injection of Ozurdex® into the crystalline lens, a remarkable reduction in the macular edema and an improvement in visual acuity were observed, suggesting that a positive outcome can be achieved without immediate surgery.

Abstract Chronic kidney disease (CKD) is an important health problem across the world affecting the adult population with an enormous social and economic burden. Calcium regulation is also affected in patients with CKD, and related to several disorders including vascular calcifications, mineral bone disorders, and cardiovascular diseases (CVD). Upper zone of growth plate and cartilage matrix (UCMA) is vitamin K-dependent protein (VKDP) and acts as a calcification inhibitor in the cardiovascular system. The molecular mechanism of UCMA action remains unclear in CKD. In the current study, we aimed to investigate serum total UCMA levels and its association with calcium metabolism parameters in CKD patients including hemodialysis (HD) patients. Thirty-seven patients with CKD stage 3-5, 41 HD patients, and 34 healthy individuals were enrolled in this cross-sectional study. Serum UCMA and calcification related protein levels (Matrix Gla Protein (MGP), Osteocalcin (OC), and Fetuin-A) were analyzed with enzyme-linked immunosorbent assay (ELISA). Calcium mineral disorder parameters (Serum Ca, P, iPTH) were quantified with routine techniques. We, for the first time, report the potential biomarker role of UCMA in CKD including HD. Serum total UCMA levels were significantly higher in patients with CKD including HD patients than the healthy controls. Also, serum UCMA levels showed negative correlations with serum calcium, and eGFR, while showed positive relationships with P, iPTH, MGP, OC. Increased total UCMA levels may have a role in the Ca metabolism disorder and related to the pathogenesis of Vascular Calcification in patients with CKD.

The joining of powder metallurgy products is of importance because of high demand in many industrial applications. In this study, the effect of welding voltage on the joint quality has been investigated using discharge arc stud welding, a low heat input welding method, without gas protection to join steel stubs to microwave sintered compacts containing a powder mixture of 26 atomic % Al and Fe (balance). It has been shown that welds with steel stubs are prone to side cracking in the weld zone and they also suffer from the oxidation of metal powders adjacent to weld zone. The forms of oxides are continuous and laminar type in welds with steel stubs and the composition of weld zone changes with increasing arc voltage.