ABSTRACT Introduction: The aim of this study is to present a series of six cases with thoracoabdominal aneurysm treated with hybrid technique in our center. Methods: Between May 2015 and December 2018, the data of six patients with thoracoabdominal aneurysms and various comorbidities who underwent visceral debranching followed by endovascular aortic aneurysm repair were reviewed retrospectively. Results: Patients’ mean age was 65.3±19.6 years. All of them were male. Comorbidities were old age, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, previous surgical interventions, and/or esophageal hemangioma. Except for one patient who underwent coronary artery bypass grafting (inflow was taken from ascending aorta), debranching was performed from the right iliac artery. Debranching of four visceral arteries (superior mesenteric artery, celiac trunk, and bilateral renal right arteries) was performed in three patients, of three visceral arteries (superior mesenteric artery, celiac trunk, right renal artery) was performed in one, and of two visceral arteries (superior mesenteric artery, celiac trunk) was performed in two patients. Great saphenous vein and 6-mm polytetrafluoroethylene grafts were used in one and five patients, respectively, for debranching. Endovascular aneurysm repair was performed following debranching procedures as soon as the patients were stabilized. In total, three patients died at the early, mid, and long-term follow-up due to multiorgan failure, pneumonia, and unknown reasons. Conclusion: Hybrid repair of thoracoabdominal aneurysms may be an alternative to fenestrated or branched endovascular stent grafts in patients with increased risk factors for open surgical thoracoabdominal aneurysm repair; however, the procedure requires experience and care.

ABSTRACT Purpose: To compare the effectiveness of biofeedback-assisted pelvic floor muscle training (PFMT) and PFMT alone on voiding parameters in women with dysfunctional voiding (DV). Materials and Methods: The patients in group 1 (34 patients) were treated with biofeedback-assisted PFMT, and the patients in group 2 (34 patients) were treated with PFMT alone for 12 weeks. The 24-hour frequency, average voided volume, maximum urine flow rate (Qmax), average urine flow rate (Qave), post-void residual urine volume (PVR), and the validated Turkish Urogenital Distress Inventory (UDI-6) symptom scores were recorded before and after 12 weeks of treatment. Results: At the end of treatment sessions, the Qmax and Qave values of the patients in group 1 were significantly higher than those in group 2, and the PVR in the patients in group 1 was significantly lower than those in group 2 (p=.026, .043, and .023, respectively). The average UDI-6 symptom scores of the patients in group 1 were significantly lower than those in group 2 (p=.034). Electromyography activity during voiding, in group 1 was significantly lower than in group 2 (41.2 vs. 64.7, respectively, p=.009). Conclusion: Biofeedback-assisted PFMT is more effective than PFMT alone in improving clinical symptoms, uroflowmetry parameters, and EMG activity during voiding.

SUMMARY: Anthropometric data, which is highly correlated with health and high level of physical capacity, is very important for police officer. The aim of this study was to examine the anthropometric data of police college students and compare in terms of gender. Fifty-two police college students (32 females and 20 males) participated in the present study. Index calculations were made by applying anthropometric test measurements to all participants. The data included anthropometric (length measurements, width measurements, circumference measurement) and index [Body Mass Index (BMI), Cormic Index (C-Index), Body Adiposity Index (BAI), Ponderal Index (PI), Conicity Index (Con-Index) Waist-to-Height Ratio (WHtR)] parameters. The Independent Sample T-Test was used to analyze the difference in groups. A statistically significant difference was found in all parameters except leg length in length measurements (p<0.05). The mean of all width measurements except shoulder width of females was higher than that of male participants. Differences were obtained in all variables except hand and hip-width (p<0.05). In circumference measurements, there was a difference between the groups in the measurement values of the relaxed arm, maximum arm, wrist, shoulder, chest, and hip circumferences (p<0.05). The BAI, PI, WHtR, and Con-Index values were significantly different between groups (p<0.05). In conclusion, the length, width, circumference, and kinanthropometric indexes of male and female police candidates differ. Although male have higher mean values in length and circumference measurements, female have a higher mean for width measurements. Females have higher mean values in general in terms of index values and they are inincreased risk group in terms of WHtR index. It can be recommended for all participants, especially females, to participate in regular physical activity after they start working.

RESUMEN: Los datos antropométricos que están fuertemente correlacionados con la salud y el alto nivel de capacidad física, son muy importantes para el oficial de policía. El objetivo de este estudio fue examinar los datos antropométricos de estudiantes universitarios de policía y compararlos en relación al género. En el estudio participaron 52 estudiantes universitarios de policía (32 mujeres y 20 hombres). Los cálculos de los índices a los participantes se realizaron aplicando mediciones de pruebas antropométricas. Los datos antropométricos incluyeron (medidas de longitud, ancho y circunferencia) además de índice [Índice de masa corporal (IMC), Índice córmico (Índice C), Índice de adiposidad corporal (IAC), Índice ponderal (IP), Índice de conicidad (Con-Índice) y Relación cintura-altura (WHtR)]. Se utilizó la prueba T para muestras independientes para analizar la diferencia entre los grupos. Se encontró una diferencia estadísticamente significativa en todos los parámetros excepto en la longitud de las piernas (p<0,05). La media de todas las medidas de ancho excepto el ancho de los hombros de las mujeres fue mayor que la de los hombres. Se obtuvieron diferencias en todas las variables excepto en el ancho de manos y caderas (p<0,05). En las medidas de circunferencia, hubo diferencia entre los grupos en el brazo relajado, brazo máximo, muñeca, hombro, pecho y cadera (p<0,05). Los valores de BAI, IPI, WHtR y Con-Index fueron significativamente diferentes entre los grupos (p<0,05). En conclusión, los índices de largo, ancho, circunferencia y cineantropométricos de los candidatos a policías difieren entre hombres y mujeres. Aunque los hombres tienen valores medios más altos en las medidas de longitud y circunferencia, las mujeres tienen una media más alta en las medidas de ancho. Las mujeres tienen valores medios más altos en general, en términos de valores de índice, y se encuentran en un grupo de mayor riesgo en términos de índice WHtR. Se puede recomendar a todos los candidatos y candidatas a policía, especialmente a las mujeres, que participen en actividades físicas regularmente después de comenzar a trabajar.

Abstract This study aimed to determine neopterin levels in the urine of industrial workers by the high-performance liquid chromatography method. Intra- and inter-day precision values for neopterin in urine were less than 3.14, and accuracy (relative error) was better than 3.00%. The limits of detection and quantification of neopterin were 0.3 and 1.0 ng/mL, respectively. Also, the developed method was applied to real samples to determine the neopterin levels in the urines of industrial workers, who have been exposed to various chemicals such as formaldehyde, heavy metals and thinners. Urine neopterin levels of industrial workers including auto painters, bodywork and furniture workers were statistically compared with healthy volunteers. The highest and lowest values of urinary neopterin for industrial workers were obtained 908.96 and 119.86 μmol/mol, respectively. Our investigation demonstrates that there is a meaningful difference in urinary neopterin levels between the workers and the control groups (P<0.05). Workers in the auto paint, body and furniture business may have been exposed to a toxic environmental exposure in their occupation. As a result, an increase in the concentration of neopterin in the urine may be important in the diagnosis and treatment of various diseases.

SUMMARY: N-Acetylcysteine (NAC) is used for contrast induced acut kidney injury (CI-AKI) prophylaxis because of its antioxidant effects. Paricalcitol, which has reno-protective effects, is likely to provide a more effective prophylaxis when added to NAC treatment. The study was designed based on this hypothesis. The study was organised to include 4 groups each consisting of 7 rats. Group 1 was the control group, and Group 2 included rats with CI-AKI. Rats in Group 3 were administered NAC at a dose of 100 mg/kg via oral gavage once a day for 5 days. Rats in group 4 were administered paricalcitol at a dose of 0.4 mcg/kg once a day for 5 days in addition to NAC. CI-AKI was induced after the treatments in both groups. The study was terminated on the sixth day. Samples were collected from the rats’ sera and kidney tissues to study oxidant and antioxidant parameters; kidney function tests were also studied. There were significant differences between the contrast nephropathy group (Group 2) and NAC and NAC+paricalcitol groups with respect to serum urea and creatinine levels. When the same groups were compared regarding oxidant (TOS-MDA) and antioxidant (TAC-Paraoxonase) parameters, we observed that the oxidant parameters increased in serum and kidney tissue samples with NAC use, and that effect was strengthened by the addition of paricalcitol to NAC treatment. However, despite increased antioxidant effectiveness, we observed no decrease in urea and creatinine levels when paricalcitol was added for CI-AKI in rats. There was no significant difference between Group 3 and Group 4. Paricalcitol provides a more potent antioxidant effect in both serum and kidney tissue samples when added to NAC treatment in rats with CI-AKI. Despite increased antioxidant parameters, however, paricalcitol does not provide a significant decrease in urea and creatinine levels.

RESUMEN: Debido a sus efectos atioxidantes la N- acetilcisteína (NAC) se usa para la profilaxis de la lesión renal aguda inducida por contraste (CI-AKI). Es probable que el paricalcitol, que tiene efectos renoprotectores, proporcione una profilaxis más eficaz cuando se agrega al tratamiento con NAC. En base a esta hipótesis el estudio fue diseñado para incluir cuatro grupos cada uno compuesto por siete ratas. El grupo 1 fue el grupo control y el grupo 2 incluyó ratas con CI-AKI. A las ratas del Grupo 3 se les administró NAC con una dosis de 100 mg/kg por sonda oral una vez al día, durante 5 días. A las ratas del grupo 4 se les administró paricalcitol a una dosis de 0,4 mcg/kg una vez al día durante 5 días, además de NAC. Se indujo CI-AKI después de los tratamientos en ambos grupos. El estudio finalizó el sexto día. Se recolectaron muestras de suero y tejidos renales de ratas para estudiar los parámetros oxidantes y antioxidantes; También se estudiaron las pruebas de función renal. Hubo diferencias significativas entre el grupo de nefropatía por contraste (Grupo 2) y los grupos NAC y NAC+paricalcitol con respecto a los niveles séricos de urea y creatinina. Cuando se compararon los mismos grupos con respecto a los parámetros oxidantes (TOS-MDA) y antioxidantes (TAC-Paraoxonase), observamos que los parámetros oxidantes aumentaron en muestras de suero y tejido renal con el uso de NAC, y ese efecto se vio reforzado por la adición de paricalcitol a tratamiento NAC. Sin embargo, a pesar de una mayor eficacia antioxidante, no observamos una disminución en los niveles de urea y creatinina cuando se agregó paricalcitol para CI-AKI en ratas. No hubo diferencias significativas entre el Grupo 3 y el Grupo 4. El paricalcitol proporciona un efecto antioxidante más potente tanto en muestras de suero como de tejido renal cuando se agrega al tratamiento con NAC en ratas con CI-AKI. Sin embargo, a pesar del aumento de los parámetros antioxidantes, el paricalcitol no proporciona una disminución sig- nificativa en los niveles de urea y creatinina.

Resumo Fundamento A insuficiência cardíaca com fração de ejeção reduzida (ICFEr) é uma doença de alta prevalência que requer hospitalizações repetidas e causa morbimortalidade significativa. Portanto, o reconhecimento precoce de preditores de resultados desfavoráveis é essencial para o manejo do paciente. Objetivo O objetivo do presente estudo é investigar a relação entre realce tardio pelo gadolínio (RTG) detectado por ressonância magnética cardíaca (RMC) e os parâmetros de repolarização, como o intervalo QT corrigido (QTc), intervalo Tp-e, ângulo QRS-T frontal detectado pelo eletrocardiograma (ECG) de 12 derivações na ICFEr. Método Neste estudo observacional, retrospectivo, de centro único, foram incluídos 97 pacientes consecutivos com ICFEr submetidos à RMC. A população do estudo foi dividida em dois grupos, de acordo com a presença de RTG. Foram registradas medidas ecocardiográficas e de RMC e características demográficas. Os intervalos QTc, intervalos Tp-e, e ângulos QRS-T frontais foram calculados a partir do ECG. Um valor de p <0,05 foi considerado estatisticamente significativo. Resultados O RTG foi detectado em 52 (53,6%) de 97 pacientes com ICFEr. Os intervalos QTc (p=0,001), intervalos Tp-e (p<0,001), e os ângulos QRS-T frontais (p<0,001) foram significativamente maiores no grupo RTG quando comparados ao grupo não-RTG. Na análise de regressão univariada realizada para investigar os preditores de RTG na ICFEr, todos os três parâmetros de repolarização alcançaram valores significativos, mas na análise multivariada o único parâmetro de repolarização que permaneceu significativo foi o intervalo Tp-e (OR = 1,085 IC 95% 1,032-1,140, p=0,001). Conclusão Com o prolongamento do intervalo Tp-e, pode-se prever a presença de fibrose miocárdica, a qual é um substrato arritmogênico, em pacientes com ICFEr.

Abstract Background Heart failure with reduced ejection fraction (HFrEF) is a highly prevalent disease that requires repeating hospitalizations, causes significant morbidity and mortality. Therefore, early recognition of poor outcome predictors is essential for patient management. Objective The aim of the present study is to investigate the relationship between late gadolinium enhancement (LGE) detected by cardiac magnetic resonance (CMR) and repolarization parameters such as corrected QT (QTc) interval, Tp-e interval, frontal QRS-T angle detected by 12 lead electrocardiograph (ECG) in HFrEF. Method In this single-center, retrospective observational study included 97 consecutive HFrEF patients who had CMR scan. Study population was divided into two groups according to the presence of LGE. Echocardiographic and CMR measurements and demographic features were recorded. QTc intervals, Tp-e intervals, frontal QRS-T angles were calculated from the ECG. A p-value less than 0.05 was considered statistically significant. Results LGE was detected in 52 (53.6%) out of 97 HFrEF patients. QTc intervals (p=0.001), Tp-e intervals (p<0.001), frontal QRS-T angles (p<0.001) were found to be significantly higher in LGE group when compared to non-LGE group. In univariate regression analysis which was performed to investigate the predictors of LGE in HFrEF, all three repolarization parameters were reached significant values but in multivariate analysis the only repolarization parameter remained significant was Tp-e interval (OR=1.085 95% CI 1.032-1.140, p=0.001). Conclusion With the prolongation of the Tp-e interval, the presence of myocardial fibrosis which is an arrhythmogenic substrate, can be predicted in patients with HFrEF.

Abstract Aim and background: the incidence of obesity has increased among children, and obesity has been considered an independent risk factor for chronic kidney disease. We aimed to determine the degree of kidney function impairment by evaluating urine neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) levels. Materials and methods: in total, 15 obese, 26 overweight, and 26 control adolescents aged 10 to 16 years were enrolled into the study. Urine samples were evaluated for NGAL and KIM-1 levels using enzyme-linked immunosorbent assay kits. We investigated the association between obesity and related comorbidities with urinary NGAL and KIM-1 excretion. Results: no significant differences were noted between the obese, overweight, and control groups in urinary NGAL and KIM-1 excretion (p = 0.327 and p = 0.917, respectively). In the obese and overweight groups urinary NGAL levels were 50.39 [30.88-74.22] in females and 26.67 [23.24-45.59] in males (p = 0.013). Also, urinary NGAL levels were increased in obese and overweight adolescents with LDL dyslipidemia at 64.12 [30.98-114.32] as compared to those without LDL dyslipidemia: 39.51 [25.59.56.37] (p = 0.024). Furthermore, a correlation was observed between insulin and homeostasis model assessment of insulin resistance levels with the NGAL/creatinine ratio in the overweight group (r = 0.515; p = 0.008, and r = 0.483; p = 0.014, respectively). Such correlation was not found in the obese group. Conclusion: the effect of obesity on renal function could not be determined in children. A longer exposure may be required for obesity-induced disruption of renal function in children. Renal function may be disrupted by dyslipidemia in obese adolescents. Furthermore, obesity impaired renal function in female adolescents. The normalization of these urinary markers as related to urine creatinine should be discussed.

Resumen Introducción: la incidencia de la obesidad en la edad infantil ha aumentado. Se considera la obesidad como un factor de riesgo independiente para el desarrollo de la enfermedad renal crónica. El objetivo de este estudio fue valorar el grado de alteración de la función renal evaluando los niveles urinarios de NGAL y KIM-1. Material y métodos: el estudio incluyó a 15 adolescentes con obesidad, 26 con sobrepeso y 26 controles sanos. Las edades de los participantes estaban entre los 10 y los 16 años. Los niveles de NGAL y KIM-1 en orina se determinaron mediante un kit ELISA. Se investigó la asociación entre la obesidad y su comorbilidad con la excreción urinaria de NGAL y KIM-1. Resultados: no se encontraron diferencias significativas en la excreción urinaria de NGAL y KIM-1 entre los sujetos con obesidad, los sujetos con sobrepeso y los controles sanos (p = 0,327 y 0,917, respectivamente). En el grupo con sobrepeso y obesidad, los niveles de NGAL en las niñas fueron de 50,39 (,88-74,), mientras que en los niños fueron de 26,67 (,-45,59) (p = 0,013). Para los sujetos con dislipemia de LDL, el nivel de NGAL fue de 64,12 (,98-114,) frente a 39,5 (,59-56,) entre los que no la tenían (p = 0,024). Se encontró correlación entre los nivles de insulina, el HOMA-IR y la ratio NGAL/creatinina en el grupo con sobrepeso (r = 0,515; p = 0,008, y r = 0,483; p = 0,014, respectivamente). En el grupo con obesidad no se encontró dicha correlación. Conclusiones: se precisa una duración más prolongada para encontrar alterada la función renal en los niños con exceso de peso. La función renal puede alterase por la dislipemia en el caso de los adolescentes con obesidad. La función renal se afecta más en las adolescentes femeninas. En el artículo se discute la normalización de estos marcadores urinarios con la creatinina en orina.

Abstract Objective: To evaluate the prognostic value of C-reactive protein to albumin ratio (CAR) in patients with severe aortic valve stenosis undergoing surgical aortic valve replacement (AVR). Methods: Four hundred seventy-six patients with severe degenerative aortic stenosis who underwent successful isolated surgical AVR were enrolled. Hospitalization due to heart failure, surgical aortic reoperation, paravalvular leakage rates, and long-term mortality were evaluated in the whole study group. The participants were divided into two groups, as 443 patients without mortality (group 1) and 33 patients with mortality (group 2) during the follow-up time. Results: CAR was lower in patients without mortality than in those with mortality during the follow-up time (0.84 [0.03-23.43] vs. 2.50 [0.22-26.55], respectively, P<0.001). Age (odds ratio [OR]: 1.062, confidence interval [CI]: 1.012-1.114, P=0.014), CAR (OR: 1.221, CI: 1.125-1.325, P<0.001), ejection fraction (OR: 0.956, CI: 0.916-0.998, P=0.042), and valve type (OR: 2.634, CI: 1.045-6.638, P=0.040) were also found to be independent predictors of long-term mortality. Additionally, rehospitalization (0.86 [0.03-26.55] vs. 1.6 [0.17-24.05], P=0.006), aortic reoperation (0.87 [0.03-26.55] vs. 1.6 [0.20-23.43], P=0.016), and moderate to severe aortic paravalvular leakage (0.86 [0.03-26.55] vs. 1.86 [0.21-19.50], P=0.023) ratios were associated with higher CAR. Conclusion: It was firstly described that CAR was strongly related with increased mortality rates in patients with isolated severe aortic stenosis after surgical AVR. Additionally, rehospitalization, risk of paravalvular leakage, and aortic reoperation rates were higher in patients with increased CAR than in those without it.

Abstract Background Alexithymia is reported to be a risk factor for depression. Psychotherapy is efficient for treatment of depression. Yet, the effect of psychotherapies on alexithymia is poorly understood. Objectives We aimed to compare Cognitive Behavioral Therapy (CBT), Existential Psychotherapy (ExP) and Supportive Counseling (SUP) for therapeutic efficacy and effect on alexithymia in depression. Methods There were 22 patients for each patient group. Sessions were performed as eight consecutive weekly and following two monthly boosters. Sixty six healthy controls were added. Prior to the sessions, patients received Sociodemographic Data Form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), Hamilton Depression Rating Scale (HDRS) and 20-item Toronto Alexithymia Scale (TAS-20). The control group received Sociodemographic Data Form, SCID-1 and TAS-20. Patients additionally received HDRS and TAS-20 after their weekly and booster sessions. Results Patients’ mean TAS-20 score was greater than of controls, however, it did not have a significant change throughout the study. Mean HDRS scores of ExP and CBT groups were lower than SUP group at the end. Discussion Alexithymia did not improve with psychotherapy. The exception was effect of ExP on externally oriented thinking. Psychotherapies all improved depression. CBT and ExP were more helpful than SUP.

RESUMO OBJETIVO: Examinamos o efeito da administração intracameral da cefuroxima sobre o estresse oxidativo e a apoptose endotelial no tecido corneano de ratos. MÉTODOS: No total, 30 ratos foram divididos em 3 grupos de 10 ratos cada (administração intracameral de cefuroxima 0,1 mg/0,01 mL (grupo cefuroxima), administração intracameral de solução salina balanceada 0,01 mL (grupo controle) ou ausência de injeção intracameral (grupo sham)). A apoptose endotelial da córnea foi avaliada por análise imuno-histoquimica usando caspase-3 e -8. O status oxidante total, o status antioxidante total, o índice de estresse oxidativo e os níveis de a paraoxonase e arilesterase foram investigados no tecido endotelial da córnea e no soro. RESULTADOS: Os níveis de paraoxonase no soro foram significativamente diferentes entre os grupos sham e cefuroxima (p=0,027). Foi também observada uma diferença significativa nos níveis de estado oxidante total entre os grupos cefuroxima e solução salina balanceada (p=0,023). Além disso, houve diferenças significativas nos níveis de status antioxidante total no tecido da córnea entre os grupos cefuroxima e sham (p<0,001) e entre os grupos cefuroxima e solução salina balanceada (p<0,001). Diferenças significativas também foram observadas nos níveis do índice de estresse oxidativo entre os grupos cefuroxima e solução salina balanceada (p=0,001) e entre os grupos cefuroxima e sham (p=0,026). De acordo com os resultados de coloração imuno-histoquimica, houve associação significativa com a atividade da caspase-3 entre os grupos cefuroxima e solução salina balanceada (p=0,007), enquanto não houve diferença significativa com a atividade da caspase-8 (p=0,541). A atividade da caspase-3 exibiu uma relação significativa entre os grupos sham e solução salina balanceada (p=0,018), mas nenhuma relação foi encontrada com a atividade da caspase-8 (p=0,623). CONCLUSÃO: O exame imuno-histoquímico revelou que a cefuroxima intracameral aumentou a apoptose quando comparada com os grupos sham e solução salina balanceada. Além disso, a cefuroxima intracameral aumentou o estresse oxidativo na córnea e induziu simultaneamente a apoptose.

ABSTRACT PURPOSE: We examined the effect of intracameral administration of cefuroxime on oxidative stress and endothelial apoptosis in rat corneal tissue. METHODS: In total, 30 rats were divided into 3 groups of 10 rats each (intracameral administration of cefuroxime 0.1 mg/0.01 mL (cefuroxime group); intracameral administration of balanced salt solution 0.01 mL (control group); or absence of intracameral injection (sham group). Corneal endothelial apoptosis was assessed by immunohistochemical analysis using caspase-3 and caspase-8. Total oxidant status, total antioxidant status, oxidative stress index, and paraoxonase and arylesterase levels were examined in corneal endothelial tissue and serum. RESULTS: Paraoxonase levels in the serum were significantly different between the sham and cefuroxime groups (p=0.027). A significant difference was also observed in total oxidant status levels between the cefuroxime and balanced salt solution groups (p=0.023). In addition, there were significant differences in total antioxidant status levels in corneal tissue between the cefuroxime and sham groups (p<0.001) and between the cefuroxime and balanced salt solution groups (p<0.001). Furthermore, significant differences were also observed in oxidative stress index levels between the cefuroxime and balanced salt solution groups (p=0.001) and between the cefuroxime and sham groups (p=0.026). According to the immunohistochemical staining results, a significant association with caspase-3 activity existed between the cefuroxime and balanced salt solution groups (p=0.007), while no significant difference was found with caspase-8 activity (p=0.541). Caspase-3 activity exhibited a significant relationship between the sham and balanced salt solution groups (p=0.018), but no relationship was found with caspase-8 activity (p=0.623). CONCLUSION: Immunohistochemical examination revealed that intracameral cefuroxime increased apoptosis when compared to the sham and balanced salt solution groups. Moreover, intracameral cefuroxime increased oxidative stress in the cornea and simultaneously induced apoptosis.

Abstract Objective Not only white blood cells but also platelets are being considered in inflammatory reactions from now on. Mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) have been shown to change in inflammatory diseases like myocardial infarction, stroke and implicated in psychiatric disorders nowadays. Our first aim is to investigate the relation of MPV and NLR with depression and secondly to assess if they change with the treatment of depression. Methods Forty-nine patients diagnosed with major depressive disorder (MDD) and hospitalized in a university hospital psychiatry inpatient unit retrospectively included in the study. Control group consisted of 48 hospital workers with no known disease. Complete blood count, Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impression-Severity Scale (CGI-S) scores at admission and at discharge were noted and compared for the patient group. Discussion MPV of depressed patients was higher than controls. When we look at admission and discharge scores of clinical scales, decrement is statistically significant for both HAM-D and CGI-S. There was decline both in MPV and NLR which were both statistically significant. Conclusion Decreasing MPV and NLR values with the treatment of depression confirm the involvement of inflammatory processes in the pathophysiology of depression.

SUMMARY: Forest litter (FL) carbon accumulation patterns can be predicted by certain tree and stand parameters to assess how variably managed forests may accumulate carbon. The aim of our study was to use tree stand data to refine methods to predict the composition of FL fragments in temperate, semi-humid black pine forests (Pinus nigra) in western Anatolia, Turkey. Predictive models were established between FL fractions (fine fragments of < 2, 2-4, and > 4 mm and coarse woody debris of branches < 5 cm, > 5 cm, cones and bark) and tree parameters (stand age, tree height, diameter at breast height, tree basal area, tree density, lowest tree crown height and tree crown thickness). We sampled 105 stands of ages < 50, 50-100, and > 100 years, that were distributed at 5 altitudinal steps (500 to 1,750 m). A multi-regression analysis was used to estimate FL fraction for different-age stands. Total FL dry biomass varied from 18 to 213 Mg/ha (average: 94 Mg/ha). The fine fragment fraction (> 4 mm) represented the largest proportion of FL (36 %). Coarse woody debris amounted for 6.6-7.8 % of the FL and branches < 5 cm accounted for the highest proportion (12.4-26.4 %) of coarse woody debris. The most influential parameters predicting FL fragment proportions included dry branch thickness, thinning rate, height and age (R2: 0.11 to 0.67). The combination of long-term observation and fine and coarse litter trapping methods should improve the estimation rates of sequestered carbon in forest ecosystems.

RESUMEN: Los patrones de acumulación del mantillo posiblemente se pueden predecir por ciertos parámetros del árbol y rodal para evaluar cómo los bosques manejados por diferentes métodos acumulan carbono. El objetivo de este estudio fue usar datos de parcelas de árboles para refinar métodos que predicen la composición de los tamaños de fragmentos del mantillo en bosques templados semi-húmedos de pino negro (Pinus nigra) en el occidente de Anatolia, Turquía. Se establecieron modelos predictivos entre los componentes del mantillo (fragmentos finos de <2, 2-4 y >4 mm y detrito leñoso grueso de ramas de <5 cm, >5 cm, piña y corteza) y parámetros de los árboles (edad, altura, dap, área basal, densidad, altura del comienzo de copa y su diámetro). Se muestrearon 105 parcelas (edades <50, 50-100, >100 años) distribuidas en cinco altitudes (500-1.750 m). Mediante análisis de multiregresión se estimaron las cantidades de los componentes del mantillo. El mantillo varió de 18 a 213 Mg/ha (promedio: 94 Mg/ha). Los fragmentos finos (>4 mm) representaron la mayor proporción (36 %). El detrito leñoso grueso representó 6,6-7,8 %; las ramas <5 cm fueron la mayor proporción de este componente (12,4-26,4 %). Las variables más influyentes para predecir las proporciones de los componentes del mantillo incluyeron el grosor de las ramas secas, tasa de raleo, altura y edad. La combinación de las observaciones de largo plazo y los métodos de captura del detrito fino y grueso deben mejorar las tasas de estimación del carbono secuestrado en los ecosistemas forestales.

Resumen Objetivos: Investigar los niveles de alfa-metil acilcoenzima-A y Netrina 1 en pacientes con y sin cáncer de próstata y determinar si estos marcadores pueden ser usados como una alternativa en el diagnóstico de cáncer de próstata en lugar del antígeno prostático específico en suero (PSA). Métodos: Fueron incluidos 175 pacientes entre 45-75 años, a quienes se les realizó una biopsia de próstata guiada por ultrasonido por presentar un nivel anormal de PSA en el suero o un tacto rectal. Se tomó una muestra de 5 mL de sangre y orina para medir los niveles de alfa-metil acilcoenzima-A y Netrina 1. Estos niveles se midieron antes del análisis de la biopsia. Resultados: La edad media de los pacientes fue de 62.7±6.4 años. Se detectó cander en 40 pacientes (22.8%), mientras que a 135 de ellos (77.2%) se les diagnóstico una hiperplasia benigna de próstata (HBP). En el grupo HBP los niveles en suero y orina de alfa-metil acilcoenzima-A y Netrina 1 fueron 13.4 ±16.9 ng/mL; 7.1 ±3.4 ng/mL; 164.1 ±46 pg/mL y 19.5 ±5.0 pg/mL respectivamente. En el grupo con cáncer de próstata los niveles en suero y orina de alfa-metil acilcoenzima-A y Netrina 1 fueron 10.2 ±9.8 ng/mL; 6.8 ±2.5 ng/mL; 159.1 ±44.1 pg/mL y 20.1 ±5.3 pg/mL respectivamente. No hubo una diferencia significativa o una correlación entre los niveles de alfa-metil acilcoenzima-A y Netrina 1 en suero y orina al comparar estos dos grupos de pacientes. Conclusiones: Los niveles de alfa-metil acilcoenzima-A y Netrina 1 en suero y orina no son una alternativa para reemplazar el PSA en suero para el diagnóstico de cáncer de próstata.

Abstract Objectives: To investigate serum and urine levels of Alpha-methylacyl-CoA-racemase (AMACR) and Netrin 1 in patients with and without prostate cancer and to determine whether these markers could be used as alternatives in diagnosis of prostate cancer instead of serum prostate specific antigen (PSA) levels. Methods: One hundred and seventy five patients between 45-75 years to whom transrectal ultrasound guided biopsies were performed for abnormal serum PSA levels or digital rectal examinations were included. The levels of AMACR and Netrin 1 levels of blood and urine samples of 5 mL those were taken prior to biopsies were measured. . Results: The mean age of the patients was 62.7 ±6.4 years. Prostate cancer was detected in 40 patients (22.8%) while 135 of them (77.2%) were diagnosed as benign prostate hyperplasia (BPH). In BPH group, serum and urine levels of AMACR and Netrin 1 were 13.4 ±16.9 ng/mL; 7.1 ±3.4 ng/mL; 164.1±46 pg/mL and 19.5 ±5.0 pg/mL respectively. The levels of serum and urine levels of AMACR and Netrin 1 were 10.2 ±9.8 ng/mL; 6.8 ±2.5 ng/mL; 159.1 ±44.1 pg/mL and 20.1 ±5.3 pg/mL respectively in prostate cancer group. There was no statistically significant difference or correlation between these two groups serum and urine AMACR and Netrin 1 results Conclusions: Serum and urine levels of AMACR and Netrin 1 were not found to be alternatives for serum PSA levels in the diagnosis of prostate cancer in this study.

Abstract Purpose: To investigate thymoquinone, curcumin and a combination of these two drugs were effective or not at the growth of liver. Methods: Forty female Wistar-Albino rats distributed into five groups of eight rats each, control, thymoquinone, curcumin, and thymoquinone/curcumin groups. Pathological specimens were studied using the Ki-67 Proliferation Index(PI); and arginase(Arg), tissue plasminogen activator(tPA), ceruloplasmin(Cer) and nitric oxide(NO) were studied in biochemical analysis. Results: Our results showed that Ki-67 proliferation index was low in Groups 1. The proliferation coefficient was significantly higher in the Group 2 and Group 4 than in the Group 1 and Group 3.(P < 0.001 between Groups 1 and 2, 1 and 4, and 3 and 4). There was no difference between Groups 2 and 4 (P = 1). The results of the biochemical Arg, tPA and Cer test showed statistically between the Group 1 and Group 2. NO showed significant differences Group 1 and 3. Conclusions: Thymoquinone and curcumin both have known positive effects on the organism. Histological and biochemical tests showed that thymoquinone is more effective than curcumin.

Abstract Background and aim: Childhood obesity is associated with an increased risk of chronic disease. We aimed to determine the association between vitamin D deficiency and cardiovascular risks in obese children. Method: The studied children were selected from obese children who were followed up at obesity clinic, aged 6-17 years. Basic demographic information and laboratory data were collected retrospectively from hospital records. Results: A total of 310 students (178 [57.4%] girls) were evaluated for 25-hydroxyvitamin D (25[OH] D) levels in late winter/spring. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 62.3%, 34.5%, and 3.2%, respectively. Insulin resistance was observed in 146 (47.1%) children; the frequencies of dyslipidemia and hypertension were 31% and 19.4%, respectively. The mean atherogenic dyslipidemia ratio was higher in the deficient group (p = 0.049). Inverse correlations of 25(OH) D levels were observed with homeostasis model assessment of insulin resistance values (r = -0.146, p = 0.010). The mean values of 25(OH) D (ng/mL) were lower in girls (12.15 ± 6.60) than in boys (16.48 ± 8.69) (p < 0.05) and in children with hypertension (11.92 ± 5.48) than in those without (14.50 ± 8.24) (p < 0.05). Conclusions: Vitamin D deficiency is observed more frequently than expected in obese children and adolescents. Our findings indicate that low 25(OH) D levels are associated with insulin resistance. Vitamin D deficiency could contribute to the morbidities associated with childhood obesity, such as insulin resistance or diabetes mellitus, increased cardiovascular/cardiometabolic risks, atherogenic dyslipidemia, and hypertension.

Resumen Introducción y objetivo: La obesidad infantil se asocia a un riesgo aumentado de enfermedades crónicas. El objetivo de este estudio es determinar la relación entre la deficiencia en vitamina D y el riesgo cardiovascular en niños obesos. Método: Se seleccionaron niños tratados en la clínica de obesidad, con edades entre 6 y 17 años. Los datos de laboratorio y la información demográfica básica se recogieron de forma retrospectiva a partir de las historias clínicas. Resultados: Se evaluaron 310 estudiantes (178, 57,4% mujeres) midiendo los niveles de vitamina D a finales de invierno y en primavera. La prevalencia de deficiencia en vitamina D, insuficiencia y suficiencia fueron 62,3%, 34,5% y 3,2% respectivamente. Se encontró resistencia insulínica en 146 niños (47,1%); mientras que la frecuencia de dislipemia e hipertensión fue de 31% y 19,4%, respectivamente. La razón de aterogenicidad debida a dislipemia fue mayor en el grupo deficiente (p = 0,049). Se encontró una correlación inversa entre los niveles de 25-OH-D y los valores de HOMA (r = -0,146; p = 0,01). Los valores medios de vitamina D (ng/Ml) fueron inferiores en niñas (12,15 ± 6,60) que en niños (16,48 ± 8,69) (p < 0,05) y en niños con hipertensión (11,92 ± 5,48 vs. 14,50 ± 8,24 en normotensos) (p < 0,05). Conclusiones: Se encontró una prevalencia de deficiencia en vitamina D en niños y adolescentes obesos superior a lo esperado. Nuestros hallazgos indican que los niveles bajos de vitamina D se asocian con resistencia insulínica. La deficiencia en vitamina D podría contribuir a las morbilidades que se asocian a la obesidad infantil, como la resistencia insulínica o la diabetes mellitus, el aumento del riesgo cardiovascular, la dislipemia y la hipertensión.