OBJECTIVE: Coronavirus disease-19 (COVID-19) is a multisystemic disease that can cause severe illness and mortality by exacerbating symptoms such as thrombosis, fibrinolysis, and inflammation. Plasminogen activator inhibitor-1 (PAI-1) plays an important role in regulating fibrinolysis and may cause thrombotic events to develop. The goal of this study is to examine the relationship between PAI-1 levels and disease severity and mortality in relation to COVID-19.
METHODS: A total of 71 hospitalized patients were diagnosed with COVID-19 using real time-polymerase chain reaction tests. Each patient underwent chest computerized tomography (CT). Data from an additional 20 volunteers without COVID-19 were included in this single-center study. Each patient’s PAI-1 data were collected at admission, and the CT severity score (CT-SS) was then calculated for each patient.
RESULTS: The patients were categorized into the control group (n=20), the survivor group (n=47), and the non-survivor group (n=24). In the non-survivor group, the mean age was 75.3±13.8, which is higher than in the survivor group (61.7±16.9) and in the control group (59.5±11.2), (p=0.001). When the PAI-1 levels were compared between each group, the non-survivor group showed the highest levels, followed by the survivor group and then the control group (p<0.001). Logistic regression analysis revealed that age, PAI-1, and disease severity independently predicted COVID-19 mortality rates. In this study, it was observed that PAI-1 levels with >10.2 ng/mL had 83% sensitivity and an 83% specificity rate when used to predict mortality after COVID-19. Then, patients were divided into severe (n=33) and non-severe (n=38) groups according to
disease severity levels. The PAI-1 levels found were higher in the severe group (p<0.001) than in the non-severe group. In the regression analysis that followed, high sensitive troponin I and PAI-1 were found to indicate disease severity levels. The CT-SS was estimated as significantly higher in the non-survivor group compared to the survivor group (p<0.001). When comparing CT-SS between the severe group and the non-severe group, this was significantly higher in the severe group (p<0.001). In addition, a strong statistically significant positive correlation was found between CT-SS and PAI-1 levels (r: 0.838, p<0.001).
CONCLUSION: Anticipating poor clinical outcomes in relation to COVID-19 is crucial. This study showed that PAI-1 levels could independently predict disease severity and mortality rates for patients with COVID-19.

OBJECTIVE: The aim of this study is to determine the level of compliance with treatment and achieving metabolic goals in type 2 diabetes mellitus (T2DM) patients who are remotely monitored with mobile health (mHealth) technologies during the pandemic.
METHODS: A total number of 86 patients were included in the study. Data from two periods were used: from 1 month before the date when the first COVID-19 case in Turkiye was reported on March 11, 2020 (Febraury 10, 2020–March 31, 2020) and from the pandemic was severe between April 01, 2020 and May 31, 2020. Participants’ mean blood glucose, step count, blood pressure, body weight, and diet compliance levels were evaluated.
RESULTS: When the blood sugar, blood pressure, and weight averages of the patients were compared between the prepandemic period and the pandemic months separately, no significant difference was observed. However, it was observed that the number of steps decreased significantly compared to the period before the pandemic (p<0.05). It was determined that 88% of the participants were able to access health services without applying to the hospital.
CONCLUSION: In this study, we showed that patients with T2DM who were followed up with mHealth technologies provided the necessary metabolic control and compliance with the treatment during the pandemic.

OBJECTIVE: Acute coronary syndrome (ACS) is one of the leading causes of mortality, globally. Atherosclerosis is an underlying factor in ACS process and coagulative cascade is activated secondary to atherosclerotic plaque rupture. Fibrinopeptide A (FPA) takes an active role in thrombus formation and is an indicator of coagulative process. We aimed to evaluate serum FPA level in patients with ACS.
METHODS: Patients diagnosed with ACS and chronic coronary syndrome (CCS), with non-obstructive coronary artery disease as a control group, were included in the study. Blood samples and demographic data of all patients were obtained at admission. Obtained data were compared between ACS and control groups.
RESULTS: The study consisted of 107 patients with ACS and 69 patients with CCS. ACS group was older (p<0.001) with male preponderance (p<0.001), more likely to had hypertension (p<0.001), and had a higher smoking rate (p<0.001). Serum FPA level was highest in the ST elevated myocardial infarction group (p<0.001). FPA>3.38 ng/mL predicted ACS with 89.7% sensitivity and 78% specificity (AUC: 0.825, 95% CI 0.745–0.905; p<0.001).
CONCLUSION: Serum FPA may be used for the differential diagnosis of ACS. In addition, patients with increased FPA may be considered to be given more aggressive antithrombotic medication.

OBJECTIVE: Some studies have reported that the systemic immune inflammatory index (SII) and neutrophil/lymphocyte ratio (NLR) provide predictive data on prognosis in gastric cancer patients. In the present study, it was aimed to examine the diagnostic and prognostic values of SII and NLR in gastric cancer.
METHODS: A total of 152 patients, operated with the diagnosis of gastric cancer and followed up in the General Surgery Department of our hospital between January 2012 and April 2018, and 152 healthy controls were included in the study.
RESULTS: The mean SII (989±685) and the mean NLR (3.9±5.2) were significantly higher in gastric cancer patients than the healthy control group (433±203 and 1.9±0.8, respectively) (p<0.001 for both). In the receiver operating characteristic analyzes, a threshold value of 892 for SII had a sensitivity of 66.7% and a specificity of 62.7% in terms of predicting 5-year survival (AUC: 0.637; p=0.076; LB: 0.475; UB: 0.799; CI 95%). The 5-year survival rate was found to be significantly higher in those with a SII of above 892 than those with a SII of 892 and below (p=0.026). The 5-year mortality risk was 0.67-fold lower in those with SII above 892 (p=0.111; 95% CI 0.4–1.1).
CONCLUSION: The present study findings show that SII and NLR are far from providing reliable data on gastric cancer prognosis.

OBJECTIVE: The purpose of the research was to assess the performance of the method of prevention of post-operative peritoneal adhesions (PAs) (author’s method) in patients of different age groups.
METHODS: Two hundred eighty-five patients were in total enrolled in the study. The patients of two age groups were divided into two groups: Group 1 (treatment group), where the author’s method was used on 143 patients, and Group 2 (control group) 142 patients, where was used the standard approach of prevention of intra-abdominal adhesions. All patients were operated in an urgent order on adhesive intestinal obstruction (AIO). The patients previously had surgery on AIO one to 3 times. Within each group, sick children and adults were identified. The gender distribution was comparable in both groups.
RESULTS: The recurrence of AIO was significantly less in Group 1 than in Group 2 (1.4% and 6.3%, respectively, p<0.05). A separate study of the results of treatment in the age aspect in groups showed some features. Among children the AIO relapse rate in study Groups 1 and 2: Early AIO-in 1 (0.86%) and 2 (1.8%) patients, respectively; late AIO-in 1 (0.86%) and 4 (3.5%), patients, respectively. Among adults who didn’t have relapse AIO during the follow-up period in Group 1. The AIO relapse rate in Group 2: Early AIO – in 1 (3.5%) and late AIO-2 (6.9%) patients, respectively.
CONCLUSION: The proposed author’s method for preventing AIO recurrence has shown its effectiveness among patients with adhesive AIO. Besides, using this method in children to reduce the AIO relapse rate by more than thrice; in adult patients, to prevent the development of clinically significant signs of PA and normalize the patient’s quality of life. (NCI-2022-4-10)

OBJECTIVE: This study was conducted to elucidate the predictive value of hematological indices, the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV), to determine the clinical outcome of placental abruption in women regarding stillbirth.
METHODS: This retrospective review of medical charts was performed in a tertiary center experienced for maternal, fetal, and neonatal care, including 89 pregnant women with placental abruption with or without stillbirth. The results of the hemogram tests with hematological indices, including the NLR, PLR, and MPV, which are the routinely obtained parameters both at admission and 4 h postoperatively, were correlated with other clinical parameters.
RESULTS: The findings showed that although there were remarkable changes in some of the clinical features of women with placental abruption with or without stillbirth, in general, the study groups were found comparable regarding these variables. The values of NLR, PLR, and MPV in women with stillbirth presented remarkable changes when hemogram tests were used as pre-operative and post-operative laboratory examinations, although these changes did not correlate with each other meaningfully.
CONCLUSION: Stillbirth is one of the most important complications of placental abruption requiring rapid diagnosis and regular follow-up after its surgical management. To fine-tune emergent management of placental abruption in women with stillbirth, the indices of NLR, PLR, and MPV calculated at the first admission as well as during follow-up of the patients have clinical value as easily obtainable laboratory findings like other hematological parameters.

OBJECTIVE: Enlargement and cystic changes in ovaries of patients with long-standing overt hypothyroidism have been described in numerous case reports. However, there are limited data about the effect of subclinical hypothyroidism (SH) on ovarian volume. The aim of the study is to evaluate the relationship between serum thyroid stimulating hormone (TSH) level and ovarian volume in prepubertal girls with SH.
METHODS: Patients who were aged between 6 and 10 years and diagnosed with SH and age-matched healthy euthyroid controls were enrolled in the study. All subjects were prepubertal.
RESULTS: Thirty-five children with SH (mean age; 7.6±1.0 years) and 50 euthyroid healthy girls (mean age; 7.7±1.2 years) were enrolled in the study. TSH and LH levels and both ovarian volumes were significantly higher in SH group than controls (p<0.05). In addition, TSH was positively correlated with ovarian volumes and LH in patients with SH (p<0.05).
CONCLUSION: The results of this study showed that ovarian volumes of prepubertal girls with SH were significantly greater than those with normal thyroid function. Although ovarian enlargement and cyst formation is well recognized in long-standing overt hypothyroidism, it has been shown for the 1st time in patients with SH.

OBJECTIVE: This study aims to reveal the oxidant and antioxidant status in nurses with chemotheropathic drug exposure and radiology unit workers exposed to ionizing radiation (IR).
METHODS: Nineteen radiology unit workers, 14 nurses, and 15 controls were included the study. All of the participants using antioxidants, vitamin supplements, smokers, any therapeutic drugs, and exposed therapeutic or diagnostic X-ray or chemotherapeutic drugs in 12 months were excluded from the study. Total and native thiols, disulfide/native thiol percent ratios (SS/SH), disulfide/total thiol percent ratios, disulfide amounts, and native thiol/total thiol percent ratios, ischemia-modified albumin (IMA) were determined.
RESULTS: Disulfide levels, disulfide/total thiol ratio, and disulfide/native thiol ratio of serum samples of both radiology unit workers and nurses were significantly higher and ratio of native thiol/total thiol was lower than the control group. The radiation dose in radiology unit workers was mean±SD: 0.02±0.009, median (min–max): 0.02 (0.001–0.04). Thiol-disulfide homeostasis was disturbed and the balance shifted in the direction of oxidant damage, even at low-dose IR exposure and normal range.
CONCLUSION: As far as we know, the current findings first demonstrate an apparent chronic oxidative stress in the subjects who were occupationally exposed to antineoplastic drugs and radiation even if annual radiation exposure dose measurements are normal.

OBJECTIVE: The objectives of this study were to determine the musculoskeletal (MSK) conditions associated with pediatric psoriasis (Pso) and to evaluate the thickness of Achilles tendon of children with Pso and healthy controls (HCs).
METHODS: Pso patients who were followed-up in dermatology outpatient clinic were referred to a pediatric rheumatology center. All patients and healthy peers were evaluated with standardized forms. Both patients and controls underwent ultrasonographic evaluation for Achilles tendon thickness.
RESULTS: A total of 55 pediatric Pso and 46 healthy children were included in the study. Of patients with Pso 56.4% had arthralgia, 25.5% had lower back pain, 18.2% had heel pain, 12.7% had hip pain, and 10.9% described morning stiffness. Arthritis was detected in 7.3%, sacroiliac tenderness in 12.7%, and enthesitis in 9.1% of the patients. Arthralgia, lower back pain, and heel pain were significantly frequent in Pso group than healthy children median left and right Achilles tendon thicknesses of Pso patients who were significantly greater than that of HCs prevalence of psoriatic arthritis (PsA) among Pso patients was 7.3%.
CONCLUSION: Evaluation of a child with Pso regularly for the MSK complaints is critical for the early recognition of PsA. Ultrasonography is a useful technique for screening Pso patients for early detection of enthesopaty.

OBJECTIVE: Many human leukocyte antigen (HLA)-B alleles are associated with an increased risk of Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) progression; however, their distribution varies among different racial/ethnic groups. Abacavir used in the treatment of AIDS significantly increases the risk of hypersensitivity reactions in patients with HLA-B*57: 01. The aim of this study was to determine the distribution of HIV-associated HLA-B subgroups (high and low resolution) and HLA-B*57: 01 associated with Abacavir sensitivity in Turkey.
METHODS: This retrospective case-control study consisted of 416 (F/M: 111/305) HIV positive patients and 416 (F/M: 111/305) healthy controls. HLA-B alleles were identified using Luminex based low-resolution method and further subgrouped by sequence-based high-resolution typing.
RESULTS: Our data showed that in patients with HIV-1 infection, HLA-B*15, *35, and *51 allele frequencies were higher, while the HLA-B*07, *14 and *55 allele frequencies were lower as compared to the controls. It was determined that HLA-B*15: 01, *35: 01, *35: 08, and *51: 01 alleles frequencies were higher in the patients with HIV-1 infection compared to the controls as HLA-B*07: 02, *14: 01, *44: 01, and *55: 01 allele frequencies were detected low. HLA-B*57: 01 allele positivity, which is important in Abacavir hypersensitivity, was lower than controls, and this difference was not statistically significant.
CONCLUSION: Our results suggest that, HLA-B*07, *14, and *55 alleles and HLA-B*07: 02, *14: 01, *44: 01, and *55: 01 subgroups might have a protective effect, while HLA-B*15, *35, and *51 alleles and HLA-B*15: 01, *35: 01, *35: 08, and *51: 01 subgroups might play a role in susceptibility to HIV-1 infection.

OBJECTIVE: The aim of this study is to determine the incidence and characteristics of newborns with subconjunctival hemorrhage (SCH).
METHODS: In our study, patient files of term infants referred to the study hospital’s ophthalmology clinic in 2018–19 were analyzed. Demographic data of infants including gestational week, birth weight, gender, and head circumference were all recorded. The frequency of SCH detection was evaluated depending on delivery type. Demographic data of infants with and without retinal hemorrhage (RH) were compared.
RESULTS: A total of 172 eyes of 86 infants were included in study. Forty-two (48.8%) of 86 neonates were male, and 44 (51.2%) were female. Mean gestational week was 38.62±1.1. SCH was detected in 31.4% (27) in the right eye, 36% (31) in the left eye, and 32.6% (28) in both eyes. The diagnosis was made at the mean of 3.74 days (range 1–20). Mean birth weight was found as 3621.1±453.3 g, head circumference as 35.4±1.3 cm, height as 50.7±2 cm, and chest circumference as 33.6±1.4 cm. Mean Apgar score in 1st min was 7.1±0.4; 5th min was 9. About 11.6% (10) of the mothers were nulliparous, and 88.4% (76) were multiparous. It was found that 79 of the deliveries were vaginal and seven with cesarean section. RH was not detected in any of the infants born with cesarean section.
CONCLUSION: SCH and RH were more common in infants born vaginally. If SCH is detected, a fundus examination should be performed to not miss possible RH.

OBJECTIVE: Chronic urticaria (CU) is a common skin disease in which the etiology involves immunological and psychological factors. Childhood traumas may disrupt the development of the neuro-immuno-cutaneous-endocrine system and start a complex pathophysiological process with inflammatory abnormalities, potentially leading to the development of skin disease. In light of this information, we believe that childhood trauma may play a role in the onset and severity of disease in CU patients. Our study aimed to discover a potential relationship between CU and childhood traumatic experiences.
METHODS: This study was conducted with 53 controls and 50 CU patients. The participants were given a questionnaire form that included sociodemographic information, Beck Anxiety Scale, Beck Depression Scale, and Childhood Trauma Questionnaire (CTQ-28).
RESULTS: The rates of childhood trauma were found to be 68% in the patient group, and 54.7% in the control group. The patient group demonstrated higher scores for moderate to severe anxiety and depression. The mean emotional abuse score was significantly higher in early onset (<35 ages) urticaria patients in comparison to late onset urticarial (≥35 ages) and the control group. It was found that depression scores were positively correlated with all abuse sub-types, excluding sexual abuse, and total CTQ-28 scores. Anxiety scores were positively correlated with emotional abuse, physical neglect, emotional neglect, and total CTQ-28 scores.
CONCLUSION: Childhood traumas are associated with the early onset and severity of disease in CU patients as well as the accompanying depression and anxiety.

OBJECTIVE: Health anxiety is defined as the negative over-interpretation of the usual physical sensations, although the person does not have any physical illness. The study aims to evaluate the health anxiety levels of individuals over the age of 18 who admit to primary healthcare institutions in Eskisehir and the factors that may be associated with it.
METHODS: This is a cross-sectional study. The study was conducted in adults who admitted to primary healthcare institutions in Eskisehir. The study group consists of 1200 individuals. For the purpose of collecting data, a questionnaire including the questions regarding the factors related to health anxiety and the Health Anxiety Scale were used. In the analysis of the data, a logarithm of The Short Health Anxiety Inventory (SHAI) scores was performed to determine the factors affecting the inventory score and hierarchical multiple linear regression analysis was used.
RESULTS: The total scores from The SHAI ranged from 1 to 47, with an mean of 16.4±8.7 and a median score of 15. Of 41.9% of study group scored above mean score. Female gender, deterioration of family income, presence of chronic disease, worsening of general health status, symptoms of mental and behavioral disorders, high number of admissions to health institutions, and hospitalization history were found to be factors affecting the level of health anxiety.
CONCLUSION: Health anxiety was found to be an important problem among those who admitted to primary healthcare institutions in Eskisehir. Providing education to individuals in risky groups in terms of health anxiety, and these groups should be closely monitoring in terms of health anxiety and providing psychosocial support when necessary will prevent excessive use of health services in the long-term.

OBJECTIVE: Neuropsychiatric assessment is essential part of child and adolescent psychiatry clinic practice, also provides important information about central nervous system dysfunctions. In studies conducted to date, it has been known that both the high frequency of psychiatric comorbidity in epileptic patients and that epilepsy comorbidity is quite common in neurodevelopmental disorders. In fact, considering the high comorbidity of epileptic abnormalities and psychiatric disorders, it has been very important to determine predictors for epileptic abnormalities in a clinical sample of child and adolescent psychiatry. In this retrospective study, we aim to determine possible predictive factors for epileptic abnormalities in a clinical sample of child and adolescent psychiatry according to Weschler Intelligence Scale for Children (WISC-R) results.
METHODS: We identified patients who had two or more rotation errors in the block design subtest of WISC-R by retrospectively scanning the system records of 2609 cases who were applied WISC-R with different prediagnoses at Gazi University Child and Adolescent Psychiatry Outpatient Clinic between January 2013 and December 2020 (n=71). After the first step identification, we selected the ones who had a previous electroencephalography (EEG) recording available for our own re-review (n=60).
RESULTS: We found 15% EEG abnormalities and ADHD is the most common diagnosis in both normal and abnormal EEG groups. Due to correlation analysis, there was a positive-mild correlation between presence of EEG abnormality and WISC-R performance (r=0.56) in intellectual disability (ID) group and a positive-strong correlation between presence of EEG abnormality and WISC-R performance-verbal scores (r=0.74) in ID group.
CONCLUSION: This study has shown that many different abnormal EEG patterns can be found in patients who have rotation errors in the block design test of WISC-R, suggesting diagnoses of ID, and having notable performance-verbal subtests scores difference and rotation errors in the block design subtest of WISC-R should be predicitive factors for epileptic abnormalities.

OBJECTIVE: The birth of a visually impaired child leads to stress, disappointment, and medical challenges for the family due to the economic and financial costs, unmet expectations of other family members, and social embarrassment-isolation of the family from society. In these families, mothers are exposed to the stressors more often than other family members, because, in most families, they are the primary caregivers. In this study, we examined the relationship between maternal attachment styles, maternal depression and anxiety levels, and behavioral problems of children with visual impairment.
METHODS: This is a case–control study. In the study group, there were 35 children with visual impairment, and in the control group, there were 31 healthy children. All mothers completed adult attachment style dimensions scales, beck depression, and anxiety inventories, and the aberrant behaviour checklist.
RESULTS: Our results demonstrated that children with visual impairment have higher levels of behavior problems including irritability, stereotypic behavior, and inappropriate speech when compared with healthy controls. Contrary to our expectations depression and anxiety, scores of mothers were similar, also, there was not a difference in terms of maternal attachment types. Interestingly, there was a positive relationship between secure attachment and depression among mothers of the visual impairment group. In other words, securely attached mothers were more depressive. On the other hand, there was a positive relationship between anxious/ambivalent attachment and the child’s irritability.
CONCLUSION: The relationship between maternal depression and secure attachment could be a consequence of higher maternal sensitivity due to a child’s impairment and should be evaluated in future studies.

OBJECTIVE: Cardiovascular magnetic resonance imaging (MRI) is a widely accepted reference imaging technique in routine cardiology clinics in many centers due to its advantages in providing preferable functional, morphologic information. However, there is little information about national experience in clinical application and findings of cardiovascular MRI. The objective of this study was to demonstrate the clinical and demographic characteristics of patients admitted to our cardiac imaging department.
METHODS: A total of 500 cardiovascular MRI examinations performed between 2016 and 2019 were enrolled in this retrospective study. Clinical indications, demographic, and cardiovascular MRI findings of the patients were retrospectively evaluated.
RESULTS: Five hundred patients (M/F=301/199) were included in this retrospective, single center study. The majority of the examinations were performed for the assessment of congenital heart disease (n=254, 50.8%). The other indications were for myocardial disease (n=160, 32%), cardiac mass (n=44, 8.8%), valvular heart disease (n=20, 4%), magnetic resonance angiography (n=12, 2.4% for aorta and pulmonary artery [n=9, 1.8%] and for coronary arteries [n=3, 0.6%]), and vasculitis (n=7, 1.7%), pericardial disease (n=3, 0.6%). Minor complication was seen during the contrast agent injection in three patients (0.06%).
CONCLUSION: Cardiovascular MRI is a reliable and accurate imaging tool in identifying the various cardiac pathology with widely accepted use in the clinical area. Our single-center experience of 500 cases demonstrates the varieties of clinical indications in daily practice that may contribute to the national data pool.

The work aimed to explore the clinical hypothesis on the possible alternative to Opiorphin and its stable analogues for treating fibromyalgia pain. Fibromyalgia is a condition characterized by chronic pain triggered by an interplay of biological and psychosocial variables, although the exact pathogenesis is still controversial. Standard therapy for low threshold tender point pain includes NSAIDs and opioid analgesics, both of which have serious adverse profiles after long-term exposure, highlighting the need for an intermediate compound capable of bridging the gap between NSAIDs and opioid analgesics. Opiorphin is an anti-nociceptive modulator which inhibits the enzyme responsible for the degradation of natural endogenous opioid neuropeptides. This paper hypothesizes and concludes that Opiorphin and its stable analogues (Sialorphine, STR-324) can be an alternative for the treatment of chronic long-standing low-threshold tender point pain associated with fibromyalgia. (NCI-2022-7-13)