Determination of pancreatic cancer risk factors, organization of imaging and screening programs for high-risk people can provide early diagnosis of the disease and prolong survival.

Aim: Candida infections develop especially in intensive care unit (ICU) patients and increase the mortality rates. So, early and accurate diagnosis of Candida infections and determination of risk factors are very important. We aimed to retrospectively investigate Candida infections in terms of species and risk factors for candidemia caused by fungi. Methods: Candida infections in critically ill patients hospitalized in the Intensive Care Unit of Bolu Abant Izzet Baysal University Training and Research Hospital between January 2014 and December 2018 were retrospectively analyzed. The isolated Candida species were evaluated according to the sample types. The cases were investigated in terms of mortality due to candidiasis, previously used antibiotics and isolated Candida species. Results: 34 Candida species isolated from fungal cultures in ICUs were included in the study. Candida albicans (73.5%) was the most prevalent species isolated (NAC 26.5%). Patients with Candida isolated in their urine samples (76%) had a higher mortality rate than patients with Candida from other regions. Conclusion: The results of our study suggest that the highest rate of candidiasis (88%) is in patients who received beta-lactam antibiotic treatment. In addition, we think that when Candida species are detected in the urine samples of critically ill patients in the ICU, care should be taken in terms of candidiasis.

Aim: To investigate the effects of using the active warming method on children with hypothermia in the perioperative period and examining the effects of hypothermia on awakening time, pain, shivering and hospital stay. Methods: This study included patients 18 years of age and younger who underwent surgery in the pediatric surgery department of a tertiary hospital. The active warming group consisted of 28 patients and the control group consisted of 29 patients. The first group of patients was actively warmed during the surgery and the second group was treated as the control group and did not actively receive any warming therapy. Preoperative body temperatures of the cases were measured. In addition, body temperatures were recorded every 15 minutes in the intraoperative and postoperative periods. Results: There was no statistically significant difference in preoperative body temperature between the control group and the active warming group. When body temperature were examined in the intraoperative period, there was no significant difference between the groups at the first 15 minutes of operation; however, the mean of the body temperature in active warming group was significantly higher than the control group at the 30th , 45th , and 60th minutes of operation. It was determined that patients in the control group had a longer stay in the hospital and the amount of time for waking at the end of the anesthesia was shorter in the active heating group than in the control group. Conclusions: The results of our study suggest that active heating with a carbon fiber resistant system is an effective method to prevent unplanned hypothermia in operated children.

Aim: Levothyroxine (L-T4) requirements in obese hypothyroid patients receiving L-T4 therapy decrease following bariatric surgery. L-T4 absorption is also thought to decrease after surgery. The purpose of this study was to evaluate L-T4 requirements in hypothyroidism cases before and after weight loss through bariatric surgery. Methods: Seventy-six cases of hypothyroidism receiving L-T4 replacement therapy and with a body mass index over 40 kg/m2 were included in the study. Patients losing at least 10% of basal body weight following bariatric surgery were assessed in terms of thyroid hormone levels and L-T4 requirements over follow-up of at least one year. The L-T4 requirements of patients in whom euthyroidism was achieved were compared in terms of bariatric surgery procedures and hypothyroidism etiology. Results: Seventy-six patients (56 women, 20 men) with a mean age of 38 years (18-51) were included in the study. Mean weight before bariatric surgery was 121.6 ± 6.8 kg, and mean body mass index was 49.5 ± 1.6 kg/m2 . Euthyroidism was confirmed at pre- and post-bariatric surgery evaluation. No statistically significant postoperative changes were determined in thyroid-stimulating hormone or free thyroxine-3 and -4 (p > 0.05). A statistically insignificant decrease was observed in L-T4 dosages after surgery in cases of Hashimoto’s thyroiditis (p = 0.064). A statistically significant decrease was determined in L-T4 dosages in cases of nonHashimoto hypothyroidism (p = 0.001). L-T4 requirements decreased in both surgical procedures (p = 0.001) Conclusion: Postoperative L-T4 requirements decrease with weight loss. In addition, no decrease appeared to occur in L-T4 absorption following the surgical procedures in this study.

Aim: Pregnancy rhinitis (PR) is characterized with nasal symptoms during pregnancy without any signs of respiratory infection and it usually disappears within 2 weeks after delivery. We aimed to investigate the relationship between pregnancy rhinitis and findings derived from anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and subjective nasal obstruction score (SNOS). Methods: This prospective, controlled study was performed in otorhinolaryngology and obstetrics and gynecology departments of our tertiary care center. A total of 30 pregnant women in the third trimester and 30 non-pregnant women were involved. All participants underwent otorhinolaryngology examination, as well as clinical evaluation for AnR, ARM and SNOS. Results: Pregnancy rhinitis was detected in 66.7% of the pregnant women. The mean AnR was 3.60 ± 1.35 in pregnant women and 0.77 ± 0.73 in the control group. Total nasal inspiratory resistance (TNID) was 0.46±0.23 in pregnant women and 0.27±0.06 in the control group. The mean SNOS was 1.37±0.72 in pregnant women and 0.57±0.63 in the control group. AnR, ARM and SNOS findings were significantly higher in pregnant women (p<0.05). There is a low positive and significant correlation between AnR, ARM, and SNOS values in pregnant women (p<0.05). Conclusion: Our data yielded that nasal obstruction and pregnancy rhinitis were common in pregnant women. Nasal symptoms and complaints must be carefully examined during pregnancy. Further prospective, controlled, randomized trials on larger series are warranted to elucidate the clinical and pathophysiological features of pregnancy rhinitis.

Aim: A successful gene therapy requires a delivery system for overcoming various biological barriers. For this, we adapted the factorial design and response surface methodology to the cationic solid lipid nanoparticle production process. Methods: Screening and optimization of formulations were carried out with factorial design with 3 factors and 3 levels using Box-Behnken Design. Then, solid lipid nanoparticles were physicochemically characterized. Furthermore, optimal SLN formulation is examined in terms of complex formation with plasmid DNA, its protection potential against nucleases, cytotoxicity profile, and storage stability. Results: Response-surface analyses demonstrated that the selected quadratic model holds significance for particle size and zeta potential. The interaction of independent variables was statistically determined. Optimization and prediction were performed using obtained second-order polynomial equations. Optimal formulation and complexes were found to be nanosized, positively charged and their polydispersity-index values below 0.3 as an indicator of being monodispersed. Cytotoxicity of the optimal formulation is compatible for further studies and no significant increase was observed in particle size until day 21 and until day 60 for polydispersity-index. Conclusion: Optimal formulation provides a good basis as a gene delivery system was produced with developed systematic. Briefly, this methodology could be used to obtain SLNs with desired conditions.

Aim: To investigate the hepatoprotective, anti-inflammatory and antioxidant effects of gallic acid (GA) against obstructive cholestasis (OC) -induced liver damage in rats. Methods: Thirty female Sprague-Dawley rats were divided into three groups. Group 1 (n=10) was the shamoperated group. In group 2 and group 3, hepatoduodenal ligament dissection was performed after laparotomy. Once the common bile duct was made apparent, it was ligated with 4/0 silk surgical suture and cut between both sutures. Group 2 (n=10) was the control group. Group 3 (n=10) was the GA group. GA (50 mg/kg) was administered by oral gavage daily for 10 days. At the end of the experiment on day 10, the rats were anesthetized. Fibrosis, inflammation, ductal proliferation and necrosis were evaluated histopathologically. Serum levels of AST, ALT, TBIL, DBIL, LDH and GGT levels were determined. In the serum and liver, TAS, TOS, MDA, TNF-a, IL-1, IL-6, and IL 10 levels were evaluated. Results: When group 2 and group 3 were compared histopathologically, fibrosis and inflammation were significantly lower in group 3. In group 3, all LFTs (except DBIL), liver and serum IL-6, IL-1, TOS, MDA, and TNF-a levels were significantly lower than group 2, whereas IL-10 and TAS values were increased. Conclusion: Findings of this research indicate that GA may be effective against OC-induced liver damage in a rat model. We presume that the beneficial effects of GA are closely associated with its antioxidant and antiinflammatory activities. Therefore, we think that using GA can save us time before resorting to the surgical method.

Aim: Multiple sclerosis (MS), which is inflammatory in its pathogenesis, damages the myelin sheath in the central nervous system (CNS) and causes axonal loss. Epicardial fat tissue (EFT), located between the myocardium and the visceral layer of the pericardium, surrounds the heart and several inflammatory cytokines is secreted from this tissue. In this study, we aimed to investigate EFT thickness in MS patients and compared with that of volunteer non-MS subjects. Methods: A total of 154 subjects comprising 61 MS patients and 93 volunteers matched for gender and age were included in our study. Epicardial fat tissue thickness was measured by echocardiography. All values were compared between groups. Results: Echocardiographic parameters were similar in both groups. However, the mean EFT thickness was significantly higher in the MS group than in the control group (p<0.001). Epicardial fat tissue thickness was also significantly correlated with the presence of MS (r=0.33, p<0.001). Conclusion: The results of our study suggest that the increase in epicardial adipose tissue thickness in MS patients may be a predictive factor for cardiovascular disease. However, the clinical significance of this finding and its relevance to MS pathogenesis should be investigated in further studies.