Aim: COVID-19 infectionsthe tissue through angiotensin converting enzyme 2 receptor, which is also expressed on endothelial cells. Endothelial dysfunction may be associated with lung involvement. Asymmetric dimethylarginine(ADMA) is an indirect marker of endothelial dysfunction. The aim of our study was to evaluate ADMA concentrations and to identify its association with lung involvement in patients with COVID-19 disease.Methods:We included 42 patients with COVID-19 infection and lung involvement (Group 1). Forty-two age and sex matched patients without pneumonia acted as the control group (Group 2). All patients gave blood samples for ADMA at the 1stmonth control visit after discharge. We compared C-reactive protein (CRP) and ADMA concentrations in addition to routine biochemical parameters between groups.Results: Patients with lung involvement had higher admission glucose, CRP, and ADMA concentrations, and displayed lower hemoglobin concentration and lymphocyte count compared to patients without lung involvement. Although patients with lung involvement had higher ADMA concentrations with respect to those without; plasma ADMA levels were also higher than normal values in control group. Multivariate analysis identified logCRP concentration (OR= 3.047, 95% CI=1.881-5.023, p<0.001)as the independent predictor for lung involvement. And, there was a correlation between ADMA and CRP (r:0.318, p:0.003).Conclusion: We revealedelevated ADMA concentrations as the surrogate of endothelial dysfunction in COVID-19 patients whether they have pneumonia or not.

Aim:To investigate the effectiveness of the non-union scoring system(NUSS)in predicting the result and in guiding the treatment by comparing the treatment methods applied to non-union patients we treat in our clinic with the treatment methods suggested by the NUSS.Methods:The study included 116 patients, who were diagnosed with long bone (femur, tibia and humerus) non-union and treated in our clinic. Of the 116 patients with non-union, 48 had femur (41.38 %), 39 had tibia (33.62%) and 29 had humerus (25%) non-union. The patient scores were calculated according to the NUSS criteria. The patients were divided into four groups according to their total scores. There were 34 patients in the first group (0-25 points), 49 patients in the second group (26-50 points), 30 patients inthe third group (51-75 points) and three patients in the fourth group (76-100 points). Results:Union that was achieved in 79 (68.10%) of all patientswas detected in 97.05% of the patients in the first group, 83.67% in the second group, and 16.66 % in the third group. Amputation, arthroplasty and arthrodesis were applied to three patients in the fourth group. While union rate was 100 % in the femur and tibia in the first group, it was 90% in the humerus. The union rates were 85.71% in the humerus, 75% inthe femur and 100% in the tibia in the second group. They were 20 % in the humerus, 15.38% in the femur and 16.66% in the tibia in the third group. The number of patients treated with the treatment proposed by the NUSS: 100% in the group 1, 83.67% in the group 2, 20% in the group 3 and 100% in the group 4. The risk of non-union in those who were not treated according to the NUSS recommendations was 28 times higher than that of others.Conclusions:The results of our study suggest that more frequent use of the NUSS procedure in non-union treatment planning may increase treatment success. In addition, NUSS can provide information about the treatment process of non-unions.

Aim: To evaluate the prevalence of Helicobacter pylori (H. pylori)and related histopathological lesions in gastric mucosa samples in this single-center study.Methods: Esophagogastroduodenoscopy and endoscopic biopsy reports of 1605 elective cases were retrospectively evaluated. Histopathological examination was evaluated according to the Sydney classification. The data were analyzed according to the prevalence of H. pylori, age, gender, gastric atrophy and intestinal metaplasia rates, and the distribution of the study group in the population below 40 years old and over 40 years old.Results: 584 males (Mean age 51.5 ± 16.5 years) and 1021 females (mean age 49.6 ± 16 years), (p = 0.03), a total of 1605 cases were included in the study. The rate of atrophy, metaplasia and H. pylori positivity in total study population were0.2%, 16%, 71%, respectively. The rate of atrophy in men and women were 1.2% and 0.8%, respectively (p = 0.006). The rate of metaplasia in men and women were 20.9% and 13.7%, respectively (p <0.001). In the population under 40 years of age, the rates of gastric atrophy and intestinal metaplasia were 0.7% and 2.5%, respectively (p = 0.02), above the age of 40, these rates were determined as 10.8% and 18.4%, respectively. (p <0.001). Conclusion: According to the data of our center, the prevalence of H. pyloriis high. In addition, the rate of intestinal metaplasia is relatively high in the male population over the age of 40.

Aim: Thyroid cancers are the most commonly encountered endocrine system malignancies. The incidence continues to rise worldwide.Our aim in this study is to investigate the frequency andhistopathological subtypes of thyroid cancer in our clinic.Methods: The present study was conducted with 3614 patients who were followed up in our endocrinology and general surgery clinic and operated with the diagnosis of multinodular and/or nodular goiter between 2015 and 2021. The histopathological types and information of patients diagnosed with thyroid cancer were obtained retrospectively from the pathology reports. Among the patients included in the study, a total of 570 people who were reported to have thyroid cancer due to histopathology were included in the study.Results: The data of a total of 3614 biopsy reports were examined for the study. Among these patients, 570 (421 females, 149 males) were operated and whose pathology reports were accessed were included in the study. The mean age of the patients was 49.12±10.4 years. As a result of the operations, malign postoperative tissue histopathology was 98.9% (n=564), and uncertain malignancy potential was reported to be 1.0% (n=6). In our study, the histopathological distribution of thyroid cancers was as follows; thyroid papillary cancer 89.4% (n=510), follicular cancer 7.3% (n=42), medullary cancer 2.1% (n=12), and malignancy potential uncertain 1.0% (n=6).Conclusion: The results of our study suggest that thyroid cancers are more common in women in our country, in parallel with the similar rates reported in the literature, with the increase worldwide.

Aim:To investigate whether there is a relationship between both massive and sub-massive pulmonary embolism(PE)and eosinophil counts in order to evaluate it as a predictor factor. Methods:This retrospective study included 108 patients (64 sub-massive and 44 massive) who received both tomographic and clinical diagnoses of pulmonary embolism, and 75 subjects served as controls. Hemogram parameters were compared between patients with massive and sub-massive pulmonary embolism and those of control groups.Results:In terms ofwhite blood cell andeosinophil counts, the lowest value was evident in the massive PE group whereas the control group had the highest value. The eosinophil counts increased significantly one week after the treatment when compared to those at the presentation with PE (0.112 (0.003-0.853) vs. (0.144 (0.011-0.914), p=0.01). Spearman correlation test showed a significant positive correlation between right ventriculardysfunction or elevated cardiac troponin leveland massive PE (r=0.54, p <0.001), whereas a negative correlation was detected between eosinophil count and the presence of massive PE(r=-0.36, p<0.001).Conclusion:The results of our study suggest that lower eosinophil counts may lead a physician to suggest a higher probability of acute massive pulmonary embolism rather than sub-massive pulmonary embolism.However, further randomized studies are required to confirm these findings.

Aim:To demonstrate the correlation between coronary collateral circulation (CCC) and atherogenic plasma index (AIP), one of the factors associated with the formation of collateral vessels.Methods:Hospital records of patients with chronic total occlusion (100% stenosis) in at least one coronary artery were evaluated. Triglycerides, HDL level, triglyceride/HDL ratio and atherogenic plasma index before coronary angiography were assessed for the 451 patients who met the study criteria. Results:Comparison of the two groups in terms of laboratory findings showed that triglyceride/HDL ratio (5.04±3.13 vs 3.56±2.12, p<0.001)and AIP (0.63±0.25 vs 0.48±0.25, p<0.001)were higher with statistical significance in the weak collateral group. The ROC analysis revealed an association between weak collateral formation and atherogenic plasma index with 64.7% sensitivity and 66.2% specificity using a cut-off value of 0.58 for AIP. Accordingly, low AIP was found to be anindependent predictor of good collateral artery formation. Conclusion:This study suggests that a high atherogenic plasma index may be an independent factor associated with poor collateral formation.

Aim: COVID-19 disease has a broad spectrum ranging from asymptomatic course to death. While data show that the prognosis of the disease will be poor in the presence of comorbidity, we witness the death of patients with no comorbidities in our clinical practice. This study aimed to investigate the effect of comorbidity on the clinical course and mortality of COVID-19 pneumonia.Methods:155 Rt-PCR (+) adult patients hospitalized at Izzet Baysal State Hospital (Bolu, Turkey) diagnosed with severe and critical pneumonia between August 2020 and February2021 were included in this single-center, retrospective study. The patients were divided into two groups with and without comorbidity, compared the severity of inflammation parameters, radiological involvement, and oxygen requirement, and evaluated their effects on mortality and hospitalization duration.Results:There was no significant difference in the severity of the computed tomography (CT) involvement, the oxygen requirement, inflammation markers, and duration of hospitalization in patients with comorbidities compared to those without. When we evaluated the patients with comorbidities in general and their subgroups, the relationship with mortality was not significant. The severity of CT involvement, high oxygen requirement, and inflammation markers such as lymphocyte, lymphocyte ratio, LDH, CRP, troponin, ferritin levels were found to be associated with mortality. Conclusions:In this study, we found that the presence of comorbidity did not affect mortality and duration of stay and that the severity of radiological involvement, the severity of hypoxemia, and the increase in inflammation markers were the determinants of mortality.

Aim: To investigate the effects of acute intestinal ischemia on plasma thiol disulphide homeostasis,which has been investigated in a limited numberof studies in the related literature.Methods:Twenty-four rats were randomized into control (operation without ischemia, GIS), and ischemia groups (GII-60, GIII-180). For ischemia, the superior mesenteric artery was sutured and the rats were exposed to 60 and 180 minutes of intestinal ischemia, respectively. Plasma TDSH was measured in blood samples collected at the end of the ischemia, and the pathology of ileum segments resected was evaluated. Results: The experimental ischemic conditions provided were confirmed by the total histopathological scoring system statistically. The levels of serum human albumin and ischemia modified albumin (IMA) in groups were detected in quite a close range of each other. There was no found a statistically significant difference for IMA between groups. The alternations on the levels of plasma TDSH parameters were observed in the study. According to ischemic conditions, the thio disulfide ratio fluctuations were detected in the plasma TDSH. Thenative thiol and total thiol levels seem to have decreased according to ischemia; no statistical difference was detected. In addition, the disulfide levels increasing according to ischemia either was not found significant statistically.Conclusion: Although this study showed the oxidative balance in intestinal ischemia had affected plasma TDSH, also it revealed that intestinalischemia didn t create a statistically significant difference between plasma TDSH components.

Aim: To investigate the effect of early systemic tranexamic acid (TRA) administration on hemoglobin (Hb) levels in rats with pelvic fracture.Method:In our study, 30 WistarAlbino rats were randomly divided into 3 groups in equal numbers and their hemoglobin levels were measured by taking blood samples from each. No trauma was applied to the first group and it was taken as the main control group of the study. Closed bilateral unstable pelvic fractures were created in all rats in groups 2 and 3. Fracture creation time is considered as minute 0. 10 minutes after the fracture wasformed, TRA was given to the 1st group, TRA to the 2nd group and saline solution to the 3rd group systemically. Hemoglobin levels were measured by taking blood samples from all rats at 30th minute and 24th hour. The initial Hbvalues obtained were normalized to 100 and the percentages of 30th minute and 24th hour values were calculated. The initial, 30th minute and 24th hour values of all groups were compared statistically with each other. The 30th minute and 24th hour values were compared statistically between the groups.Results:No death was observed within 24 hours in all three groups. When the first Hbvalues of each group are normalized to 100, the mean Hbpercentages were calculated in the first group as 99.54 and 99.84 at 30 minutesand 24hour, respectively; 92.95 and 87.73 in the second group; and 87.95 and 73.16 in the third group. When these values obtained were compared statistically within the groups (initial, 30th minute, 24th hour Hbpercentages), there was no significant difference between the initial, 30th minute and 24th hour values in group 1. However, a statistically significant difference was found between the initial, 30th minute and 24th hour values in group 2 and 3 (p<0.01). In the comparison between the groups, a statistically significant difference was found between group 1-2, group 1-3 and group 2-3 between both 30th minute and 24th hour values (p<0.01).Conclusion:In rats with bilateral unstable pelvic fractures due to blunt pelvistrauma, early administrationof TRA after trauma significantly reduced the first 24-hour decrease in Hbvalue. Our study supports the early and prehospital use of TRA in traumas that are predicted to progress with acute bleeding, such as unstable pelvic fractures.