Intra-gastric balloon with lifestyle modification: a promising therapeutic option for overweight and obese patients with metabolic dysfunction-associated steatotic liver disease

BACKGROUND

Data on effects of intra-gastric balloon (IGB) on metabolic dysfunction-associated steatotic liver disease (MASLD) are scarce, in part with contradictory results, and mainly obtained in tertiary care patients with diabetes and other comorbidities. We here explore effects of IGB in patients with MASLD referred to a first-line obesity clinic.

METHODS

In this prospective cohort study, patients with at least significant fibrosis (≥ F2) and/or severe steatosis (S3) according to screening transient elastography (FibroScan®) were offered a second FibroScan® after 6 months lifestyle modification with or without IGB (based on patient preference).

RESULTS

50 of 100 consecutively screened patients (generally non-diabetic) qualified for repeated evaluation and 29 (58%) of those had a second FibroScan®. At baseline, at least significant fibrosis was present in 28% and severe steatosis in 91%. IGB was placed in 19 patients (59%), whereas 10 patients (41%) preferred only lifestyle modification (no differences in baseline characteristics between both groups). After 6 months, liver stiffness decreased markedly in the IGB group (median: from 6.0 to 4.9 kPa, p = 0.005), but not in the lifestyle modification only group (median: from 5.5 to 6.9 kPa, p = 0.477). Steatosis improved in both groups, (controlled attenuation parameter values; IGB, mean ± SD: from 328 ± 34 to 272 ± 62 dB/m, p = 0.006: lifestyle modification only, mean ± SD: from 344 ± 33 to 305 ± 43 dB/m: p = 0.006).

CONCLUSION

Both steatosis and fibrosis improve markedly in overweight/obese patients with MASLD after 6 months IGB combined with lifestyle modification. Our results warrant further research into long-term effect of IGB in these patients.

Gaseous elemental mercury emissions from informal E-Waste recycling facilities in Pakistan

Detrimental effects of mercury (Hg) on ecosystems and human health have been well-documented. Whereas emissions of gaseous elemental mercury (GEM) from e-waste recycling have been reported in developed countries, much less is known about the situation in the Global South. Using a total of 132 passive air samplers, seasonally resolved concentrations of GEM in air were measured continuously at 32 informal e-waste recycling facilities and background location in Pakistan for a period of one year between September 2020 and December 2021. Annual average GEM concentrations at the studied locations ranged from 1.8 to 92 ng m-3. Among the studied cities, higher concentrations were measured in Karachi (mean ± s.d: 17 ± 22, range: 4.2-92 ng m-3), Lahore (16 ± 4.2, 8.2-22 ng m-3) and Peshawar (15 ± 17, 4.9-80 ng m-3), while lower levels were measured in Hyderabad (6.9 ± 6.2, 3.1-25 ng m-3), consistent with a higher rate of informal recycling activities in metropolitan areas. Seasonally, higher GEM levels occurred during autumn (15 ± 16: 3.3-92 ng m-3) and summer (13 ± 8.7: 1.8-80 ng m-3) than in winter (12 ± 8.4: 2.5-49 ng m-3) and spring (9.2 ± 7.3: 1.8-80 ng m-3), possibly reflecting enhanced volatilization at higher temperatures and/or varying magnitude of recycling operations in different seasons. Policies and strict regulations related to e-waste management should be developed and implemented urgently in the country.

Seasonal variability of airborne mold concentrations as related to dust in a coastal urban area in the Eastern Mediterranean

Recent studies have demonstrated that the amount of specific airborne mold types and their concentrations increase during dust events. This study investigates the seasonal variation of airborne mold concentrations before, during, and after the dust transport in an eastern Mediterranean coastal area, Izmir city, Turkey. A total of 136 airborne mold samples were collected between September 2020 and May 2021. Two different culture media, namely Potato Dextrose Agar (PDA) and Malt-Extract Agar (MEA), were used for enumeration and genus-based identification of the airborne mold. In addition to culture media, the influences of air temperature, relative humidity, and particulate matter equal to or less than 10 µm (PM10) were also investigated seasonally. The HYSPLIT trajectory model and web-based simulation results were mainly used to determine dusty days. The mean total mold concentrations (TMC) on dusty days (543 Colony Forming Unit (CFU)/m3 on PDA and 668 CFU/m3 on MEA) were approximately 2-2.5 times higher than those on non-dusty days (288 CFU/m3 on PDA and 254 CFU/m3 on MEA) for both culture media. TMC levels showed seasonal variations (p < 0.001), indicating that meteorological parameters influenced mold concentrations and compositions. Some mold genera, including Cladosporium sp., Chrysosporium sp., Aspergillus sp., Bipolaris sp., Alternaria sp., and yeast, were found higher during dusty days than non-dusty days. Thus, dust event impacts levels and types of airborne molds and has implications for regions where long-range dust transport widely occurs.

First Dark Matter Search with Nuclear Recoils from the XENONnT Experiment

We report on the first search for nuclear recoils from dark matter in the form of weakly interacting massive particles (WIMPs) with the XENONnT experiment, which is based on a two-phase time projection chamber with a sensitive liquid xenon mass of 5.9 ton. During the (1.09±0.03)  ton yr exposure used for this search, the intrinsic ^{85}Kr and ^{222}Rn concentrations in the liquid target are reduced to unprecedentedly low levels, giving an electronic recoil background rate of (15.8±1.3)  events/ton yr keV in the region of interest. A blind analysis of nuclear recoil events with energies between 3.3 and 60.5 keV finds no significant excess. This leads to a minimum upper limit on the spin-independent WIMP-nucleon cross section of 2.58×10^{-47}  cm^{2} for a WIMP mass of 28  GeV/c^{2} at 90% confidence level. Limits for spin-dependent interactions are also provided. Both the limit and the sensitivity for the full range of WIMP masses analyzed here improve on previous results obtained with the XENON1T experiment for the same exposure.

Searching for Heavy Dark Matter near the Planck Mass with XENON1T

Multiple viable theoretical models predict heavy dark matter particles with a mass close to the Planck mass, a range relatively unexplored by current experimental measurements. We use 219.4 days of data collected with the XENON1T experiment to conduct a blind search for signals from multiply interacting massive particles (MIMPs). Their unique track signature allows a targeted analysis with only 0.05 expected background events from muons. Following unblinding, we observe no signal candidate events. This Letter places strong constraints on spin-independent interactions of dark matter particles with a mass between 1×10^{12} and 2×10^{17}  GeV/c^{2}. In addition, we present the first exclusion limits on spin-dependent MIMP-neutron and MIMP-proton cross sections for dark matter particles with masses close to the Planck scale.

Evaluation of the Effects of Different Natural Dietary Feed Additives on Performance and Intestinal Histomorphology in Quails

The aim of the present study was to investigate the influence of a commercial probiotic and a commercial essential oil blend and their mixture, as a natural feed additive, on growth parameters live weight (LW), live weight gain (LWG), feed intake (FI), feed conversion ratio (FCR), carcass yield (CY) and small intestinal histomorphology of quails. A total of 200 1-day-old Japanese (Coturnix coturnix japonica) quails, including both males and females, were divided into four groups containing 50 quails and treated as follows: (1) a control treatment without medication (2) 18 g ton-1 probiotic;  (3) 300 g ton-1  essential oil blend  and (4) 18 g ton-1  probiotic plus 300 g ton-1 essential oil blend. The results of the research show that the additives added to quail diets do not have a significant effect (P > 0.05) on the performance parameters of LW, LWG, FI and FCR. However, significant differences (P < 0.05) were found in the CY, which is one of the performance parameters. A probiotic addition of 18 g ton -1 (treatment 1) to the quail diet resulted in a significant increase (P < 0.05) in carcass yield. Moreover, the addition of natural feed additives such as probiotics, essential oil blends and mixture to quail diets caused significant (P < 0.001) increases in villus heights and crypt depth in the duodenum and ileum segments. In addition, significant (P < 0.05) enlargements were found in the villus surface area in the experimental groups compared to the control group. In conclusion, in this study, it was determined that the addition of feed additives, which are developed as an alternative to antibiotics to the quail diet did not have a negative effect on performance and caused significant differences in the effective parameters in the evaluation of intestinal health.

Search for New Physics in Electronic Recoil Data from XENONnT

We report on a blinded analysis of low-energy electronic recoil data from the first science run of the XENONnT dark matter experiment. Novel subsystems and the increased 5.9 ton liquid xenon target reduced the background in the (1, 30) keV search region to (15.8±1.3)  events/(ton×year×keV), the lowest ever achieved in a dark matter detector and ∼5 times lower than in XENON1T. With an exposure of 1.16 ton-years, we observe no excess above background and set stringent new limits on solar axions, an enhanced neutrino magnetic moment, and bosonic dark matter.

AB0212 COMPARISON OF THE EFFECTS OF POLYPHARMACY IN THE TREATMENT OF RHEUMATOID ARTHRITIS PATIENTS AND PSORIATIC ARTHRITIS PATIENTS WITH PERIPHERAL JOINT INVOLVEMENT

Background

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are chronic, progressive inflammatory diseases that can be accompanied by other diseases. These patients use several medications, especially due to their comorbidities and widespread pain. In recent years, with the increase in the lifespan of individuals, the concept of polypharmacy has become more prominent. Accordingly, in our study, we aimed to present the prevalence of polypharmacy and its effects on these diseases.

Objectives

Demonstrating the prevalence of polypharmacy in RA and PsA, which are among the most frequently encountered inflammatory arthritides, and the effects of polypharmacy on disease activity.

Methods

This study included PsA patients with only peripheral joint involvement and no distal interphalangeal joint involvement and RA patients. The numbers of medications used by the patients at the onset of their treatment and in the sixth month of their treatment were recorded. Non-prescribed (over the counter), topical and herbal/homeopathic medications were excluded. Polypharmacy was accepted as the simultaneous use of at least five medications by the person. Disease activity score in 28 joints C-reactive protein (DAS-28 CRP) was used for disease activity for both diseases. In addition to these, the scores of the patients who attended their follow-ups in the 12th month were calculated and analyzed. The Charlson Comorbidity Index (CCI) scores of the patient were calculated based on their chronic diseases.

Results

The sample of the study included 232 RA and 73 PsA patients. Demographic and some clinical characteristics are shown in Table 1. The mean numbers of medication used by the patients at the onset of their treatment were respectively 5.09±2.89 and 4.03±2.7 for the RA and PsA patients, whereas these mean numbers were found consecutively as 8.67±3.58 and 7.71±3.3 in the sixth month of their treatment. Polypharmacy was present in the sixth month of the treatment in 217 (93.5%) RA and 61 (83.6%) PsA patients.

Table 1.

Demographic and some clinical features

RA (n=232)PSA (n=73)Age (mean±SD)55.2±13.6648.4±13.43Age Group<65 years171(73.7)65(89)≥65 years61(26.3)8(11)SexFemale, n (%)172(74.1)50(68.5)Male, n (%)60(25.9)23(31.5)Current smoker, n (%)82(35.3)33(45.2)The numbers of medication used8.67±3.587.71±3.3Polypharmacy at the Beginning of Treatment115(49.6)28(38.4)Polypharmacy in the sixth month of treatment217(93.5)61(83.6)CCI (n=232/72) (mean±SD)1.25±0.881.31±0.710th month DAS-28 CRP (mean±SD)4.91±1.284.68±1.036th month DAS-28 CRP (mean±SD)3.14±1.062.86±0.9912th month DAS-28 CRP (n=83/29) (mean±SD)2.73±1.182.8±1.12

While the mean ages of the RA and PsA patients who had polypharmacy treatment at the beginning were respectively 59.21±12.65 and 53.5±13.81, their ages were significantly higher than the ages of those who did not receive polypharmacy treatment (respectively, 51.26±13.53 and 45.22±12.3).

In RA ve PsA patients, the status of polypharmacy is higher in the groups in the groups aged 65 and over than those under 65 years of age, and it is statistically significant (p=0.001 and p=0.048, respectively). The risk of polypharmacy in people over 65 years of age in RA patients was 8.2 times, and the risk of polypharmacy in people over 65 years old in PSA patients was increased 6.3 times (p=0.015).

In both the RA and PSA groups, patients with baseline polypharmacy had statistically significantly higher DAS-28 CRP scores at 6 months of treatment than those without baseline polypharmacy. (p<0.001). While the higher DAS-28 CRP score was maintained at 12 months in the RA group with polypharmacy at baseline (p=0.006), this was not significant in the PSA group (p=0.07).

Conclusion

Polypharmacy was present both at the time of diagnosis and in the treatment process in the RA and PsA patients, and the presence of polypharmacy at the beginning of the treatment was among the factors that affected the treatment of these patients by significantly affecting their 6th-month DAS-28 CRP values.

Disclosure of Interests

None declared

Evaluation of occurrence, fate and removal of priority phthalate esters (PAEs) in wastewater and sewage sludge by advanced biological treatment, waste stabilization pond and constructed wetland

Phthalate Esters (PAEs), detected in high concentrations generally in treated wastewater discharged from wastewater treatment plants (WWTPs), are important pollutants that restrict the reuse of wastewater. Investigating the fate of these endocrine-disrupting chemicals in WWTPs is crucial in order to protect both receiving environments and ecosystems. For this purpose, di(2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DNOP) and benzyl butyl phthalate (BBP) in the group of PAEs were monitored in simultaneously both in wastewater and sludge lines of selected two nature-based WWTPs and one advanced biological WWTP. Although it was frequently stated that phthalates were significantly removed in WWTPs in many studies found in literature, negative removal efficiencies of selected phthalates in investigated WWTPs during the sampling period were observed generally in this study. One of the reasons for this concentration increase could be releasing of phthalates from microplastics in wastewater during the treatment process or the desorption of PAEs from treatment sludge. DNOP was the compound with the highest concentration increase at almost each treatment unit of the three WWTPs. On the other hand, total PAEs load was 1997 g d^-1 in advanced biological WWTP and adsorption onto sludge of PAEs were determined as 90%. The side-stream total load returned from the decanter supernatant was 0.02% of the total PAEs load coming to advanced biological WWTP from the sewer system. As a result of detailed statistical analysis, the correlation between raw wastewater and primary clarifier (PC) effluent was determined as an increasing linear relation for DEHP and DNOP. On the other hand, moderate and strong correlations were observed both between septic tank and constructed wetland (CW) processes with raw wastewater. In the waste stabilization pond (WSP), while a significant correlation was not found between the sludge line data, homogeneous variance, strong and moderate correlations were obtained in the wastewater line data. However, while mean differences for all investigated PAEs were not significant (p > 0.05) in the wastewater line, mean differences of DEHP (p < 0.05) were significant in the sludge line according to ANOVA analysis.

An Intervention Study to Increase the Medication Compliance of 60 Years and Older Individuals

Background

In older age, taking medication at the desired level contributes to the health and well-being, and therefore, constitutes an essential part of the effectiveness of treatment and ultimately desired public health impact and reduced healthcare budgets. However, it is known that medication compliance among older persons is frequently not at a desired level. Therefore, in this study, it was aimed to increase medication compliance through an educational intervention for patients aged 60 and over, who applied to two healthcare facilities in Ankara, Turkey.

Methods

This intervention study was implemented in two public health hospitals between March and June 2019. 315 people aged 60 and over participated in the study. The intervention tool was the “teach-back” method. SPSS program was used for data entry and analysis. P value less than 0.05 was indicated for statistical significance.

Results

Mean age of the participants was found to be 70.16±7.9 for the control group and 70.27±7.4 for the intervention group. In the intervention group, a statistically significant increase was found in the capacity of learning the long-term benefits of drugs, their side effects and storage conditions, and knowing when the drugs shouldn't be taken, and repeating information about the drugs used (p = 0.000).

Conclusions

This study has revealed that medication compliance among older individuals can be increased with an appropriate communication and training method in healthcare settings. Time allocated by health workers in this regard has a potential to respond to the compliance-related needs. With the “Teach-back” method utilized in the interactions between older patients and health workers, it is possible to attain meaningful, large-scale and cost-effective public health outcomes that contribute to the clinical benefits of treatments and the effectiveness of health systems.

Key messages

Older people are open to receive information on the actual health needs. A well-structured interaction between healthcare workers and patients involving “teach-back” method contributes to medication compliance among the elderly.

The prevalence of non-vascular pulmonary manifestations in Takayasu's Arteritis patients: A Retrospective multi-centred Turkish cohort study

Objectives Takayasu's arteritis (TAK) is a rare vasculitis characterized by inflammation of intermediate- to large-size arteries. Although pulmonary artery involvement (PAI) is an expected finding in some TAK patients, data on non-vascular pulmonary involvement (NVPI) are limited. We aimed to investigate the frequency of NVPI, including parenchymal infiltration, nodules/cavities, pleural effusion, and haemorrhage, in TAK.Method We assembled a retrospective cohort of TAK patients from nine tertiary centres in Turkey. The demographics and clinical characteristics of patients were extracted from medical records and the imaging findings were evaluated for pulmonary manifestations.Results As of January 2021, 319 TAK patients (female/male 276/43; mean age 42.4 ± 13.5 years) were recruited. Eighty-two patients had cough and/or dyspnoea and four had haemoptysis as pulmonary symptoms. On computed tomography assessment, the overall frequency of NVPI was 7.2%; parenchymal infiltrations were present in 10 (3.1%), pleural effusion in eight (2.5%), nodules/cavities in six (1.9%), and pulmonary haemorrhage in four patients (1.3%). In the whole cohort, 10.3% of patients had pulmonary artery hypertension (PAH) and 5.6% had PAI. Among patients with PAH or PAI, the overall frequency of NVPI was significantly higher than in the rest of the group.Conclusions In this TAK cohort from Turkey, we observed NVPI in 7.2% of patients, with parenchymal infiltrations being the most common, followed by pleural effusion. Notably, NVPI was more frequent in patients with PAH or PAI. Although not as common as PAI, NVPI should be kept in mind, especially in TAK patients with PAH or PAI.

Existence of SARS-CoV-2 RNA on ambient particulate matter samples: A nationwide study in Turkey

Coronavirus disease 2019 (COVID-19) is caused by the SARS-CoV-2 virus and has been affecting the world since the end of 2019. The disease led to significant mortality and morbidity in Turkey, since the first case was reported on March 11th, 2020. Studies suggest a positive association between air pollution and SARS-CoV-2 infection. The aim of the present study was to investigate the role of ambient particulate matters (PM), as potential carriers for SARS-CoV-2. Ambient PM samples in various size ranges were collected from 13 sites including urban and urban-background locations and hospital gardens in 10 cities across Turkey between 13th of May and 14th of June 2020 to investigate the possible presence of SARS-CoV-2 RNA on ambient PM. A total of 203 daily samples (TSP, n = 80; PM_2.5, n = 33; PM_2.5-10, n = 23; PM₁₀μm, n = 19; and 6 size segregated PM, n = 48) were collected using various samplers. The N1 gene and RdRP gene expressions were analyzed for the presence of SARS-CoV-2, as suggested by the Centers for Disease Control and Prevention (CDC). According to real time (RT)-PCR and three-dimensional (3D) digital (d) PCR analysis, dual RdRP and N1 gene positivity were detected in 20 (9.8%) samples. Ambient PM-bound SARS-CoV-2 was analyzed quantitatively and the air concentrations of the virus ranged from 0.1 copies/m³ to 23 copies/m³. The highest percentages of virus detection on PM samples were from hospital gardens in Tekirdağ, Zonguldak, and Istanbul, especially in PM_2.5 mode. Findings of this study have suggested that SARS-CoV-2 may be transported by ambient particles, especially at sites close to the infection hot-spots. However, whether this has an impact on the spread of the virus infection remains to be determined.

Letter to the Editor: Adjusting Anterior Thigh Muscle Measurements Using Ultrasound in Sarcopenia

We have read with great interest the recently published article by Tsukasaki et al (1). We congratulate the authors for drawing attention to regional muscle mass measurements for evaluating sarcopenia. As they highlighted, age-related muscle loss occurs initially in the anterior thigh muscles that predominantly contain fast-twitch (type II) fibers (2). Therefore, regional muscle mass and functional assessments are important for the early diagnosis and follow-up of sarcopenia (2). In this regard, computed tomography (CT), magnetic resonance imaging, ultrasound (US) and dual-energy X-ray absorptiometry (DXA) techniques give opportunity for regional muscle mass measurements. Likewise, the authors compared the relationships among regional/total muscle mass measurements, muscle power, strength and performance tests. Although we agree with them in general, we would like to add further.

Maternal and fetal outcomes of COVID-19, SARS, and MERS: a narrative review on the current knowledge

OBJECTIVE

Coronavirus infections, including SARS, MERS and COVID-19 have significant impact on global health as well as on pregnancies. The aim of this review was to enlighten and summarize the cumulative knowledge regarding the relationship between Coronavirus outbreaks and pregnancy.

MATERIALS AND METHODS

Literature search was commenced in order to analyze the maternofetal effects of Coronavirus outbreaks.

RESULTS

Fever and cough are the most common presenting symptoms of COVID-19 which mostly affects pregnant women in their 3rd trimester with a maternal mortality rate of  0-77%  and fetal and neonatal mortality rates of 1.2%. Fetal demise is common in critically ill pregnant. Pregnancy seems as a worsening factor for SARS and MERS epidemics and both infections affect prominently 3rd trimester pregnancies, although abortion (57%) is a significant risk for cases of early pregnancy. Clinical course of COVID-19, SARS and MERS may be rapid and worse in pregnant women than non-pregnant individuals. Cesarean section is the choice of delivery in most reported women due to mostly obstetrical reasons, although vaginal delivery seems not a worsening factor for the disease.

CONCLUSIONS

COVID-19, SARS and MERS have significant detrimental effect on pregnancy. Rapid intervention, treatment, and intensive care support are essential for infected pregnant. Timely delivery is important in order to avoid intrauterine fetal death.

Assessment of sources and pollution state of trace and toxic elements in street dust in a metropolitan city

Street dust and urban soil samples are significant part of environmental compartments to evaluate the contamination levels in urban and industrial zones. This study was carried out to ascertain the concentrations of trace and toxic elements in Izmir street dusts collected from 20 different sites dominating by industrial (four sites), residential (seven sites) and traffic (nine sites) areas, and also to figure out the exposure of adults and children to the elemental toxicity in dust. In order to measure the total and soluble concentrations of elements, the dust samples were analyzed with ICP-MS methodology. The results indicated that concentrations of anthropogenic-based elements are homogenously spread out in whole Izmir city in a similar way to crustal-based elements. This indicates that traffic and residential heating were dominant pollutant sources throughout the city dusts. The health risk assessment showed that elemental non-carcinogenic risks are lower than limit value. However, the cancer risks exceed the acceptable level for As and Cr. According to source apportionment analysis, seven factors were defined for trace elements for all site data.

Preliminary report of in vitro and in vivo effectiveness of dornase alfa on SARS-CoV-2 infection

Dornase alfa, the recombinant form of the human DNase I enzyme, breaks down neutrophil extracellular traps (NET) that include a vast amount of DNA fragments, histones, microbicidal proteins and oxidant enzymes released from necrotic neutrophils in the highly viscous mucus of cystic fibrosis patients. Dornase alfa has been used for decades in patients with cystic fibrosis to reduce the viscoelasticity of respiratory tract secretions, to decrease the severity of respiratory tract infections, and to improve lung function. Previous studies have linked abnormal NET formations to lung diseases, especially to acute respiratory distress syndrome (ARDS). It is well known that novel coronavirus disease 2019 (COVID-19) pneumonia progresses to ARDS and even multiple organ failure. High blood neutrophil levels are an early indicator of COVID-19 and predict severe respiratory diseases. Also it is reported that mucus structure in COVID-19 is very similar to that in cystic fibrosis due to the accumulation of excessive NET in the lungs. In this study, we showed the recovery of three individuals with COVID-19 after including dornase alfa in their treatment. We followed clinical improvement in the radiological analysis (two of three cases), oxygen saturation (Spo₂), respiratory rate, disappearance of dyspnoea, coughing and a decrease in NET formation and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load after the treatment. Also here, we share our preliminary results suggesting that dornase alfa has an anti-viral effect against SARS-CoV-2 infection in a green monkey kidney cell line, Vero, and a bovine kidney cell line, MDBK, without determined cytotoxicity on healthy peripheral blood mononuclear cells.

Occurrence, loadings and removal of EU-priority polycyclic aromatic hydrocarbons (PAHs) in wastewater and sludge by advanced biological treatment, stabilization pond and constructed wetland

Eight polycyclic aromatic hydrocarbon (PAH) compounds which have been accepted as priority micropollutants by European Union (EU) were analyzed both in wastewater and sludge lines throughout three full scale (located in city, sub-province and village) WWTPs during 12-month sampling period. Investigated WWTPs have different treatment types including advanced biological treatment, stabilization pond (SP) and constructed wetland (CW). Removal efficiencies for total PAH compounds varied from 48% in CW to 85% in advanced biological treatment plant. The maximum concentrations of 360-2282 ng/L observed for naphthalene in raw wastewater were decreased to 103-370 ng/L by treatment processes. Minimum concentration were detected for benzo(k)fluoranthene (B[k]F) and benzo(g,h,i)perylene (B[g,h,i]P) ranged between 8 and 12 ng/L and 19-33 ng/L, respectively. While minimum removal efficiencies were obtained for B[k]F and B[g,h,i]P maximum removal efficiencies were obtained for naphthalene in all WWTPs. PAHs present in minimum and maximum levels in the sludge samples were detected as 54 and 6826 ng/g for the B[g,h,I]P and naphthalene, respectively. Considering the removal mechanisms, PAHs have been determined to be removed by biodegradation or vaporization up to 84% and by settling (adsorption onto sludge) up to 2%. The greatest portion (99%) of naphthalene and anthracene were determined to be biodegraded or vaporized in biological treatment due to their low molecular weights. On the other hand, mechanism of adsorption onto sludge was determined as negligible for these two compounds. In addition, approximately 14% of PAHs were discharged to the receiving environment. Among the different WWTP types investigated, advanced biological treatment was found to be the most efficient plant for the removal of PAH compounds.

SAT0613-HPR EFFECT OF CERVICAL STABILIZATION EXERCISES ON CERVICAL POSITION ERROR IN PATIENTS WITH SPONDYLOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL

Background:

Proprioception sense might be deteriorated due to joint related diseases. Different exercise programs were shown beneficial for improving proprioception sense. However, the effect of exercise on cervical position error was not investigated in patients with axial spondyloarthritis (axSpA).

Objectives:

To investigate the effect of cervical stabilization exercises on cervical position error in patients with axSpA.

Methods:

Thirty-nine patients with axSpA were randomly allocated into two groups as exercise group (n: 20, 11 males) and control group (n: 19, 12 males). All patients were evaluated regarding to physical characteristics (age, body-mass index), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), functional status (Bath Ankylosing Spondylitis Functional Index), and spinal mobility (Bath Ankylosing Spondylitis Metrology Index). Cervical position error was evaluated in flexion, extension, rotation and lateral flexion directions and was calculated using a special formula (1). All evaluations were performed at baseline and after six weeks. Exercise group performed a progressive home-based cervical stabilization exercise program, while the control group did not receive any exercise intervention. Exercise adherence control and exercise progression was delivered by sending messages and video instructions via a freeware and cross-platform messaging service (WhatsApp Messenger) in a weekly basis.

Results:

Baseline physical and disease related characteristics were similar between groups (p>0.05, table 1). Exercise group showed significant improvements in all directions related to cervical proprioception following six weeks (p<0.05, Table 2), however, no improvements were observed in the control group (p>0.05, Table 2).

Table 1.

Comparison of the Groups at Baseline

Exercise Group (n: 20)Median (IQR 25/75)Control Group (n: 19)Median (IQR 25/75)p*Physical CharacteristicsAge (years)40.5 (36.0/52.5)44.0 (39.0/49.5)0.496Body-Mass Index (kg/m2)27.5 (24.5/30.2)26.8 (23.6/29.3)0.569Disease Related CharacteristicsBASDAI (score)2.0 (1.0/3.3)1.8 (1.3/2.5)0.687BASMI Total (score)2.9 (1.7/4.1)2.3 (1.8/3.1)0.127BASFI (score)1.8 (0.6/2.9)1.2 (1.0/2.2)0.496

*Mann-Whitney U Test, IQR 25/75: Interquartile range 25/75, BASDAI: Bath Ankylosing Spondylitis Disease Activity Index, BASMI: Bath Ankylosing Spondylitis Metrology Index, BASFI: Bath Ankylosing Spondylitis Functional Index, p<0.05.

Table 2.

In-Group Comparison of Cervical Position Sense Error

BeforeMedian (IQR 25/75)AfterMedian (IQR 25/75)p*Exercise Group (n: 20)Flexion(o)4.9 (2.2/7.0)2.8 (1.7/3.8)0.033Extension(o)4.5 (3.3/6.4)3.1 (1.8/4.8)0.040Right Rotation(o)5.2 (3.0/8.9)3.7 (1.9/4.7)0.006Left Rotation(o)4.3 (2.5/5.0)2.8 (2.2/3.3)0.017Right Lateral Flexion(o)4.9 (3.3/6.8)2.3 (1.8/3.7)0.009Left Lateral Flexion(o)4.3 (2.1/6.7)2.0 (1.5/3.4)0.010Control Group (n: 19)Flexion(o)6.3 (3.5/7.3)5.2 (3.8/7.0)0.856Extension(o)5.5 (4.5/7.3)4.1 (3.3/8.2)0.809Right Rotation(o)6.4 (4.3/9.0)5.5 (3.0/8.5)0.472Left Rotation(o)5.4 (3.5/7.9)5.0 (3.5/7.2)0.778Right Lateral Flexion(o)5.9 (3.6/8.4)4.3 (2.7/7.7)0.717Left Lateral Flexion(o)3.8 (2.4/5.6)4.9 (2.9/5.7)0.904

*Wilcoxon Signed Rank Test, IQR 25/75: Interquartile range 25/75,o: degree, p<0.05.

Conclusion:

A six-week cervical stabilization exercise program is beneficial for impaired cervical proprioception sense in patients with axSpA.

References:

[1]Dugailly P-M, De Santis R, Tits M, Sobczak S, Vigne A, Feipel V. Head repositioning accuracy in patients with neck pain and asymptomatic subjects: concurrent validity, influence of motion speed, motion direction and target distance. European Spine Journal. 2015;24:2885-2891.

Disclosure of Interests:

None declared

The utility of TNF-α, IL-6 and IL-10 in the diagnosis and/or follow-up food allergy

BACKGROUND

Several pro-inflammatory and anti-inflammatory mediators play a role in the immunopathogenesis of food allergy (FA). The aim of this study was to investigate the utility of serum biomarkers like interleukin (IL)-10, TNF-α, and IL-6 in the diagnosis and/or follow-up of FA.

METHODS

Sixty (25 females, 41.6%) newly diagnosed FA patients [IgE mediated (group-1, n=37), non-IgE (group-2, n=23)] with a median age of nine (1-33) months were enrolled. Twenty-four healthy children with a median age of eight (1-36) months constituted the control group (CG). In all the subjects, serum TNF-α, IL-6 and IL-10 levels were evaluated at the time of diagnosis and reassessed four weeks after therapeutic elimination diet (TED).

RESULTS

The mean white blood cell count and median absolute eosinophile count of the CG were significantly lower than group-1 (p values were 0.019 and 0.006, respectively). The mean absolute neutrophile count and the median IL-6 were significantly higher in group-1 when compared with group-2 (p values were 0.005 and 0.032, respectively. Median TNF-α and IL-6 levels were significantly higher in the pre-TED among all patients (p values were 0.005 and 0.018, respectively). In group-1, median TNF-α and IL-6 levels decreased significantly after TED (p values were 0.01 and 0.029, respectively).

CONCLUSIONS

Our findings support the role of inflammation in the pathogenesis of FA. Serum TNF-α and IL-6 levels may be useful markers for follow-up in FA, especially among IgE-mediated FA patients. Evaluation of IL-10 results was not sufficient for an interpretation of clinical tolerance.

P371 Right ventricle end-systolic remodeling index in patients with atrial septal defect and severe pulmonary arterial hypertension

Background Outcome of patients with atrial septal defect (ASD) and severe pulmonary arterial hypertension (PAH) relates to right ventricular (RV) function.

Magnetic resonance imaging (MRI) remains the gold standard for evaluating the RV function but it is not used routinely. We investigated the relationship between MRI and multiple echocardiography parameters, including the Right Ventricle End-Systolic Remodeling Index (RVESRI), a new prognostic marker in patients with PAH.

Methods 23 patients with ASD and severe PAH (median age 49y.o.[39-59], Sp0 2 92% [90-95], WHO functional class II or III, mean pulmonary artery pressure 51mmHg [40-59]) were included between 2014 and 2018. All patients underwent MRI and echocardiography assessment. Echocardiographic measurements of RV remodeling and function included TAPSE, RV fractional area change (RVFAC), peak systolic velocity of the tricuspid valve (S’TV), right atrial (RA) area, RV strain, Systolic to diastolic ratio, eccentricity index and RVESRI, defined by septum length divided by lateral wall length (Figure 1). Pericardial effusion was noted.

Results Median RV ejection fraction (EF) evaluated with MRI was 46 % [34-59]. RV dysfunction (RVEF &lt; 45%) was observed in 43% of patients. Median RVFAC and

RVESRI were 29.6%[23-34] and 1.6[1.4-1.7] respectively. By spearman correlation, RVFAC and RVESRI were significantly correlated to RVEF (Rho 0.62, p &lt; 0.007 and

Rho -0.51,p &lt; 0.02 respectively). By linear regression, RVFAC and RVESRI were also correlated to RVEF (R 2 =0.36, p &lt; 0.003 and R 2 =0.34, p &lt; 0.08). Pericardial effusion was associated with RV dysfunction (p&lt; 0.008) and a lower RVFAC (p &lt; 0.01). TAPSE, S’TV and RV strain were not correlated with RVEF.

Conclusion RVFAC, RVESRI and pericardial effusion were markers of RV dysfunction in patients with ASD and severe PAH. RVESRI appears as a simple and reliable parameter for follow-up. Its prognostic value in patients with CHD remains to be demonstrated.

Evaluation of pentraxin-3 in familial Mediterranean fever patients during attack and attack-free periods

INTRODUCTION

Pentraxin-3 (PTX-3) is a prototype of pentraxin proteins that have been shown to be involved in acute phase response. In this study, we aimed to investigate the relationship between PTX-3 levels and familial Mediterranean fever (FMF) disease, and to evaluate PTX-3 as a novel diagnostic marker of FMF.

METHOD

Forty-three male patients diagnosed with FMF and 42 healthy individuals were included in the study. Patients with other inflammatory diseases and patients who used drugs having anti-inflammatory properties were excluded from the research. Blood samples were obtained during both attack and attack-free periods.

RESULTS

Patient attack periods were confirmed by combining physical examination and elevation of acute phase reactants. Acute phase reactants were significantly higher in attack versus attack-free periods (p < 0.01), however PTX-3 levels were not significantly different between the two periods. Additionally, PTX-3 levels in FMF patients were higher than in controls in both attack (917.29 ± 725.29 vs 451.83 ± 291.95, p < 0.01) and attack-free periods (748.23 ± 487.53 vs 451.83 ± 291.95, p < 0.01).

CONCLUSION

In this study, we showed that PTX-3 levels, in both FMF attack and attack-free periods, were significantly higher than in the control group. Finally, PTX-3 may be a promising biomarker for FMF diagnosis and may predict FMF attacks (Tab. 2, Fig. 2, Ref. 18).

Determination of real-world emission factors of trace metals, EC, OC, BTEX, and semivolatile organic compounds (PAHs, PCBs and PCNs) in a rural tunnel in Bilecik, Turkey

A field study was performed in a rural tunnel to determine pollutant concentrations, sources and on road vehicle emission factors (EFs) of particulate matter, trace metals, elemental carbon (EC), organic carbon (OC), benzene, toluene, ethyl benzene and xylenes (BTEX), and polycyclic aromatic hydrocarbons (PAHs). Emission factors (EFs) for polychlorinated naphthalenes (PCNs) and polychlorinated biphenyls (PCBs) were also determined. A 12-day extensive sampling campaign during morning and afternoon periods at inlet and exit stations of the tunnel was conducted. Morphology of the particles was also investigated by Scanning Electron Microcopy (SEM). Correlation analysis, factor analysis and diagnostic PAH ratios were utilized to identify emission sources of trace metals. Identified sources include brake wear (33%), resuspension of road dust (15%), tyre wear (12%), exhaust emissions (10%), and lubricants (9%). Based on the PAH diagnostic ratios, major sources of PAHs were estimated as diesel emissions. EFs were comparable with the literature and varied from 31.5 to 295.4 mg vehicle^-1 km^-1 with an average of 129.2 ± 80 mg vehicle^-1 km^-1 for PM_2.5. PM_2.5-10 EFs varied between 15.9 and 236.1 mg vehicle^-1 km^-1 with an average of 96 ± 30 mg vehicle^-1 km^-1. Average EC EFs were 40.3 ± 9.8 mg vehicle^-1 km^-1 for PM_2.5 samples and 19.5 ± 0.5 mg vehicle^-1 km^-1 for PM_2.5-10 samples while OC EFs were 33.7 ± 18 and 15.5 ± 8.4 mg vehicle^-1 km^-1 for fine and coarse particles, respectively. EFs of elements were generally 2 (Al) to 59 (Mg) times higher than those previously reported in the literature. Compared to literature, relatively higher EFs for Σ₁₃PAHs (range: 48.1-168 μg vehicle^-1 km^-1, average: 84.3 ± 46.4 μg vehicle^-1 km^-1) were obtained. BTEX emission factors were in the range of 4.2 ± 4.7 mg vehicle^-1 km^-1 (m + p-xylene) and 16.7 ± 10.5 mg vehicle^-1 km^-1 (toluene). Average EFs for ΣPCBs and ΣPCNs were 12.06 ± 5.3 μg vehicle^-1 km^-1 and 88.9 ± 70.4 ng vehicle^-1 km^-1, respectively.

Evaluation of Mediterranean diet adherence in patients with a history of coronary revascularization

INTRODUCTION

Lifestyle modification is an important component of the secondary prevention strategies; and a healthy diet is one of the cornerstones in management of the coronary heart disease. We aimed to investigate the dietary habits of the patients with history of coronary revascularization, characteristics of the ones with good adherence by using alternate MedDiet questionnaire.

METHODS

We included outpatients who had a history of coronary revascularization at least 6 months prior to enrollment. Each participant filled out a questionnaire to collect the data of demographics and clinical characteristics. Alternate MedDiet score was calculated to evaluate the Mediterranean style dietary adherence. Alternate MedDiet was originally based on 14-item questionnaire; we adjusted it to our population (max 13 points).

RESULTS

We enrolled 226 consecutive outpatients (age 61.7±10.9 years, 72% males). The median duration after revascularization was 60 months. A total of 112 (49.6%) patients had previous percutaneous coronary intervention (PCI), 77 (34.1%) had coronary by-pass graft surgery (CABG), and 36 (15.9%) had both revascularization procedures. The median MedDiet score was 6. Patients were stratified into two subgroups (MedDiet score ≥7 vs. <7). A total of 61 (26.9%) patients had MedDiet score ≥7. By univariate analysis, good MedDiet scores were associated with older age, waist circumference, body mass index, high education level, regular follow-up, duration after first revascularization and revascularization with CABG+PCI. In the multivariate analysis, high education level (P=.002, OR=8.212, 95%CI: 2.155-31.291) and duration after revascularization (P=.034, OR=1.007, 95%CI: 1.001-1.013) were independent predictors of good MedDiet scores.

CONCLUSION

The adherence rate to a healthy diet was low in patients with previous coronary revascularization. MedDiet score seems to be practical and useful item to evaluate the dietary habits in outpatient setting. Mediterranean diet adherence rates were associated with high education level, and duration after revascularization.

The ameliorative effects of Ginkgo biloba on apoptosis, LH-R expression and sperm morphology anomaly in testicular torsion and detorsion

Torsion/detorsion (T/D) induces testicular damages in both germinal epithelial and interstitial tissues. Ginkgo biloba extract (GbE) exerts antioxidant and free radical scavenger. We investigated the effect of GbE on testicular tissues, Leydig and sperm cells in rats injured with T/D. Twenty-eight Wistar albino rats were randomly assigned into four groups (Control, GbE, Treatment: T/D+GbE, T/D). T/D performed to the rats in torsion, treatment received GbE (50 mg/kg) 1 hr before T/D, GbE group received only GbE (50 mg/kg) and control was defined as sham group. After T/D, the testes along with epididymis were removed and processed. LH-R expression, apoptosis, sperm morphology and histopathological damage scores were determined for each group. Testicular T/D caused significant increases in apoptosis and sperm morphology anomaly, and a significant decrease in Johnsen's testicular biopsy scores, LH-R expression of Leydig cell and normal sperm cell count. GbE ameliorated testicular histopathology and caused significant increases in LH-R expression, normal sperm cell count in the treated and particularly GbE group. Consequently, GbE may prevent testicular injury and enhance Leydig and sperm cell activity following both T/D and normal situation owing to its antioxidant, anti-apoptotic, free radical scavenger and anti-inflammatory effects.

Assessment of seasonal and spatial variations of physicochemical parameters and trace elements along a heavily polluted effluent-dominated stream

This study focuses on a heavily polluted effluent-dominated stream that passes through an industrialized region near Izmir, Turkey. The intermittent creek receives domestic and industrial discharges of Kemalpaşa District Center and its neighborhoods and more than 180 factories of the organized industrial zone. A monitoring campaign was conducted on the creek and samples were taken in two different seasons with distinct hydrological characteristics from 20 stations along the creek to quantify the quality status of water and sediment columns. A number of physicochemical parameters, heavy metals, and trace elements were measured by field and laboratory techniques to assess the status of creek's water and sediment quality. The spatial and temporal variations were determined, and statistical tools were used to conduct an environmental forensic overview along the creek. A geo-accumulation index and a modified heavy metal pollution index were calculated to cumulatively assess the quality of sediment and water columns, respectively. The results revealed that the creek was under significant pollution load from the industrial zone where metal processing, food and beverage production, marble and natural stone manufacturing, and paper production are made. In particular, elements such as Co, Cu, Cd, Mn, Ni, Pb, Zn, and Zr were found to be above the surface water quality standard values. Similarly, B, Cr, Ni, Cu, Zn, and Sn were determined to be in extreme levels in the sediment column with values exceeding the probable effect concentrations.

Celastrol ameliorates acetaminophen-induced oxidative stress and cytotoxicity in HepG2 cells

Acetaminophen (APAP) is the most commonly used analgesic and antipyretic drug in the world. However, hepatotoxicity caused by APAP overdose is the most frequent cause of acute liver failure worldwide and oxidative stress involved in the pathogenesis of APAP hepatotoxicity. Celastrol is a natural triterpenoid derived from Tripterygium wilfordii Hook F. that exhibits antioxidant, anti-inflammatory, and antitumor activities. In this study, we aimed to investigate the potential ameliorative effects of celastrol against APAP-induced cytotoxicity and oxidative stress. Human hepatocellular carcinoma cells (HepG2) were incubated with 20 mM of APAP for 24 h and posttreated with 50 nM, 100 nM, or 200 nM of celastrol for a further 24 h. The methylthiazolyldiphenyl-tetrazolium bromide, lactate dehydrogenase, and neutral red uptake assays showed celastrol posttreatments recovered cell viability and cell membrane integrity in a concentration-dependent manner. Celastrol posttreatments exerted a significant increase in the glutathione content and a decrease in the malondialdehyde and protein carbonylation levels. Also, celastrol posttreatments attenuated the APAP-induced oxidative stress by raising glutathione peroxidase, glutathione reductase, and catalase activities. However, superoxide dismutase activity did not change. In conclusion, celastrol treatment may improve cell viability and increase cellular antioxidant defense in HepG2 cells. These results suggest that celastrol may have the potential to ameliorate the APAP-induced oxidative stress and cytotoxicity.

Mathematical Modelling of Vibration Response Characteristics for Dissimilar Hot Plate Welded Polyamide 6 Composite Beams

This study is concerned with the mathematical modelling of the vibration response characteristic of a special dissimilar composite beam based on experimental modal analysis. Here, experimental modal analyses of three different dissimilar polyamide 6 composite beams, which are connected to each other by hot plate welding are performed. The measured natural frequencies are compared with finite element predictions for verification purposes. Modal information obtained by experiments is used to construct a mathematical model representing vibration response characteristic of beams by applying multi degree of freedom curve fitting method. The model showing modal characteristics of dissimilar beams is now ready to be used in different kinds of excitations to predict the frequency response of vibration.

Spatial variation of PAHs and PCBs in coastal air, seawater, and sediments in a heavily industrialized region

Concurrent coastal seawater (n = 22), sediment (n = 22), and atmospheric samples (n = 10) were collected in the Aliaga industrial region, Turkey, to explore the spatial variation, sources, and air-seawater exchange of polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs). Seawater Σ₁₆PAH concentrations (particle + dissolved) ranged between 5107 and 294,624 pg L^-1, while Σ₄₁PCB concentrations were in the range of 880-50,829 pg L^-1. Levels in sediments were highly variable ranging between 35.5-49,682 and 2.7-2450 μg kg^-1 in dry weight for Σ₁₆PAHs and Σ₄₁PCBs, respectively. Atmospheric concentrations varied between 1791-274,974 and 104-20,083 pg m^-3 for Σ₁₆PAHs and Σ₄₁PCBs, respectively. Sediment organic matter (OM) content and levels of Σ₁₆PAHs and Σ₄₁PCBs correlated weakly (r ² = 0.19-0.23, p < 0.05) suggesting that the spatial variations of PAHs and PCBs were mainly affected by local sources rather than their sorption to OM. The geographical distribution of PAH and PCB concentrations in air, seawater, and sediment and factor analysis on the sediment levels pointed out that the major sources in the region are steel plants, petroleum refinery, petrochemical complex, ship breaking, loading/unloading activities at the ports, vehicular emissions, and fossil fuel combustion emissions. The direction of the air-seawater exchange was also explored by estimating seawater fugacity fractions of PAHs and PCBs. For PAHs, the number of cases implying deposition (43.0%) and volatilization (39.5%) was similar, while for PCBs, the number of cases implying volatilization (60.4%) was much higher compared to deposition (21.6%). Fugacity fractions were generally <0.36 (deposition) at the sites close to industrial and ship breaking activities where the highest seawater and sediment levels were measured, implying that atmospheric deposition is an important mechanism affecting seawater and sediment PAH and PCB levels.

Effects of habitual knuckle cracking on metacarpal cartilage thickness and grip strength

Joint cracking involves a manipulation of the finger joints resulting in an audible crack. This study aimed to determine whether habitual knuckle cracking (KC) leads to an alteration in grip strength and metacarpal head (MH) cartilage thickness. Thirty-five habitual knuckle crackers (cracking their joints ≥5times/day) (20 M, 15 F, aged 19-27 years) and 35 age-, gender-, and body mass index-matched non-crackers were enrolled in the study. MH cartilage thickness was measured with ultrasound and grip strength was measured with an analog Jamar hand dynamometer. Grip strength was similar between groups (P>0.05). Habitual knuckle crackers had thicker MH cartilage in the dominant and non-dominant hands than those of the controls (P=0.038 and P=0.005, respectively). There was no correlation between MH cartilage thickness and grip strength in both groups (P>0.05). While habitual KC does not affect handgrip strength, it appears to be associated with increased MH cartilage thickness.

Polychlorinated naphthalene (PCN) emissions from scrap processing steel plants with electric-arc furnaces

Polychlorinated naphthalene (PCN) emissions of scrap iron processing steel plants were explored by measuring concentrations in stack gases of five plants, in the atmosphere (n=11) at a site close to those plants, and in soil at several sites in the region (n=40) in Aliaga, Izmir, Turkey. Observed stack-gas Σ₃₂PCN levels from the plants without scrap preheating (189±157ngNm^-3, average±SD, n=4) showed that they are substantial PCN emitting sources. Stack-gas Σ₃₂PCN level for the plant with scrap preheating was considerably higher (1262ngNm^-3). Similarly, Σ₃₂PCN emission factor for this plant was substantially higher (11.9mgton^-1) compared to those without scrap preheating (1.30±0.98mgton^-1). Results have also suggested that the investigated steel plants emit large quantities of fugitive particle-phase PCNs. Measured soil Σ₃₂PCN concentrations that are considered to be representative of the atmospheric levels were greatly variable in the region, ranging between 0.003 and 10.02μgkg^-1 (dry wt). Their spatial distribution showed that main PCN sources in the region were the iron-steel plants. Ambient air levels (1620±800pgm^-3) were substantially higher than ones observed around the world and in the study area verifying that the steel plants with electric arc furnaces (EAFs) are important PCN sources. Investigation of possible mechanisms suggested that the combustion processes also contribute to emissions from EAFs in addition to evaporation of PCNs present in the scrap iron.

Investigation of spatial distributions and sources of persistent organic pollutants (POPs) in a heavily polluted industrial region using tree components

Spatial distributions of persistent organic pollutants (POPs) were investigated in Iskenderun industrial region in Turkey. POP concentrations were measured in different tree components (i.e., pine needle, branch, bark, and stem) collected at several industrial and background sites (n = 27). Also, air, litter, and soil samples were analyzed to determine the relationship of atmospheric pollutants with tree components, litter, and soil. Spatial variation of measured concentrations and factor analysis showed that the iron-steel plants are the most important POP sources in Iskenderun area. Correlations of ambient air levels to those measured in soil, litter, and tree components were significant showing that POPs are exchanged between atmosphere and these compartments. Results have suggested that tree components, litter and soil could be used to determine the spatial distributions and sources of atmospheric POPs in a region. POP quantities (mg/ha) accumulated in different tree components, litter, and soil were also predicted. Generally, the highest quantities were accumulated by stem and needles. In terms of overall inventory, including trees, litter and soil, the highest accumulated quantities were found in soil followed by trees and litter, indicating that in addition to soil, vegetation is a notable reservoir accumulating POPs. Ambient air POP concentrations were also estimated using a bark/air partitioning model. The estimated/measured ratios were close to 1.0 for several compounds and the results showed that the atmospheric POP concentrations could be estimated from the bark measurements within factors of 0.23-3.07, 1.02-6.67, 0.63-7.44, 1.07-3.37 for polycyclic aromatic hydrocarbons, polychlorinated biphenyls, polychlorinated naphthalenes, and polybrominated diphenyl ethers, respectively.

Polymorphisms in ADAMTS4 and ADAMTS5 are not linked to susceptibility to knee osteoarthritis in the Turkish population

Considering the functions of aggrecanase-1 (ADAMTS4) and -2 (ADAMTS5), which are thought to be the two major enzymes responsible for the destruction of aggrecans in arthritic diseases, we investigated whether important polymorphisms in the ADAMTS4 and ADAMTS5 genes affect osteoarthritis (OA) susceptibility. Our study took place in Mugla, Turkey. Ninety-five cases were recruited following OA diagnosis (72 women and 23 men), and 80 individuals without any symptoms or radiographic signs of OA (56 women and 24 men) were chosen as healthy controls. After obtaining DNA from patients and control subjects, ADAMTS4 and ADAMTS5 genotypes were determined using the ABI Prism StepOnePlus Real-Time system. In addition, we categorized patients based on OA grade. There were no significant differences in the genotype distributions of the four polymorphisms between the groups (P > 0.05). Moreover, ADAMTS4 and ADAMTS5 allele frequencies did not differ between OA and control participants (P > 0.05). These findings suggest that the ADAMTS4 (rs4233367 and rs11807350) and ADAMTS5 (rs226794 and rs2830585) variants examined may not contribute to susceptibility to knee OA in the Turkish population. Other gene polymorphisms should be assessed in order to explain variations in OA susceptibility.

Intraperitoneal Administration of Low Dose Aluminium in The Rat: How Good is It to Produce a Model for Alzheimer Disease

Since neurotoxicity of aluminium (Al) resembles the progressive neurodegeneration observed in Alzheimer Disease (AD), Al administration in several ways has been used to produce AD model. Intraperitoneal (ip) low dose (4.2 mg/ kg) Al injection in rats for long periods is the preferred method by some researchers. In this paper, the efficiency of this method for producing an AD model was evaluated. In this study, we looked at the neuropathology of Al and the characteristic lesions of AD by histological and immunohistochemical techniques and determined oxidative stress markers in the brains of Al-treated and control rats. We also made electrophysiological recordings at the hippocampus and evaluated possible behavioural changes by Morris water maze test. However, no pathologic changes occurred in the animals except for an impairment in long-term potentiation (LTP) in the hippocampus (e.g. the LTPs of population spike (PS) amplitude at 15 min post-tetanus were measured as 217±27% in Al-treated rats and as 240±42% in sham-treated rats, of baseline PS amplitude). According to the findings of the present study, low dose of ip Al in rats is not sufficient to produce a good AD model. Higher doses (≥10 mg/kg) should be used.

Unenhanced respiratory-navigated NATIVE® TrueFISP magnetic resonance angiography in the evaluation of renal arteries: Comparison with contrast-enhanced magnetic resonance angiography

PURPOSE

To compare unenhanced three-dimensional (3D) NATIVE^® true fast imaging with steady-state precession (TrueFISP) magnetic resonance (MR) angiography with the more conventional MR angiography technique obtained after intravenous administration of a gadolinium chelate in the evaluation of renal arteries and their branches in patients with suspected renal artery stenosis.

MATERIALS AND METHODS

A total of 39 patients (25 men, 14 women) with a mean age of 51.4±17.5years (SD) (range: 10-82years) were included in the study. All patients with suspected renal artery stenosis underwent unenhanced 3D NATIVE^® TrueFISP MR angiography and contrast-enhanced MR angiography. The two MR angiography methods were compared by two independent readers for image quality using a four-point scale, diagnostic performance and grading of renal artery stenosis on a total of 78 renal arteries.

RESULTS

For both readers image quality of unenhanced 3D NATIVE^® TrueFISP MR angiography (3.12 to 3.63) was greater than that of contrast-enhanced MR angiography (1.94 to 2.71) for renal artery ostium-trunk and the left renal artery segmental branches. The sensitivity of 3D NATIVE^® TrueFISP MR angiography for the diagnosis of renal artery stenosis was 100% for both readers for the right renal artery and 66% and 80% for the left renal artery for reader 1 and reader 2, respectively. Agreement between 3D NATIVE^® TrueFISP MR angiography and CE-MR angiography was 95% (74/78) for reader 1 and 92% (72/78) for reader 2.

CONCLUSION

Unenhanced NATIVE^® TrueFISP magnetic resonance angiography can play an additional role in the evaluation of renal arteries in patients with hypertension, especially in subjects at risk of nephrogenic systemic fibrosis.

Carotid and cerebral CT angiography using low volume of iodinated contrast material and low tube voltage

PURPOSE

To evaluate image quality of carotid computed tomography angiography (CTA) using a low voltage (80kV) and low amount of iodinated contrast material.

MATERIALS-METHODS

A total of 101 patients referred for carotid CTA were randomly assigned to receive a specific protocol. In group A patients received intravenous administration of contrast material at a dose of 1mL/kg and CTA examinations were performed at 100kV. In group B, patients received intravenous administration of contrast material at a dose of 0.5mL/kg and CTA examinations were performed at 80kV. The same nonionic iodinated contrast material containing 370mg of iodine per mL was used in both groups. Attenuation values were measured from the center of specific arterial segments using regions of interest. Attenuation values above 300HU were accepted as significant. Institutional review board approval was obtained.

RESULTS

A total of 50 patients were included in group A (38 men, 12 women; mean age, 63.56 years±13.18 [SD]) and 51 patients in group B (33 men, 18 women; mean age, 59.60 years±16.63 [SD]). A total of 1615 arterial segments (1515 common carotid artery-middle cerebral artery and 101 aortic arches) were analyzed. Venous contamination was not observed in either group. The mean attenuation values of all arterial segments in both groups were greater than 300HU. Mean arterial attenuation value in group B (499.22HU±97.25 [SD]) was significantly greater than in group A (374.36HU±73.79 [SD]) (P<0.01). Hemodynamically significant stenosis (grade III stenosis or >70%) was detected in 2 segments in group A and in 3 segments in group B, while grade IV stenosis (occlusion) was detected in 2 segments in group B. Distal common carotid artery dissection was detected in 1 patient and aortic dissection was detected in 1 patient in group B. Total dose-length product (DLP) value was significantly greater in group A (225.74mGy·cm±21.80 [SD]) than in group B (116.60mGy·cm±21.22 [SD]) (P<0.01). The mean tube current was similar in group A (2013.11mAs±195.92 [SD]) and in group B (2096.64 mAs±309.03 [SD]) (P<0.05).

CONCLUSION

Carotid and cerebral CTA examinations using 128-section CT can be successfully obtained using an imaging protocol that combines low voltage and 50% reduction in the volume of iodinated contrast material. This provides good image quality with low radiation dose.

The apoptotic effects of silibinin on MDA-MB-231 and MCF-7 human breast carcinoma cells

Background:

Silibinin is a bioactive flavonolignan extracted from milk thistle, known as Silybum marianum. Silibinin exerts strong antiproliferative, proapoptotic, and anti-inflammatory effects. Many studies have shown that silibinin inhibits experimentally induced malignancies of the liver, prostate, skin, and colon as well as promotes inhibition of the proliferation of cancer cell lines in vitro. This study aimed to investigate the effects of silibinin on the human breast carcinoma cell lines MDA-MB-231 and MCF-7 in monolayer and spheroid cultures.

Method:

The MDA-MB-231 and MCF-7 cell lines were cultured in both monolayer and spheroid cultures. Cells were treated with silibinin at 24, 48, and 72 h of incubation. The 5-bromo-2′-deoxyuridine labeling index was used to determine the cells of the synthesis phase. Poly-ADP-ribose-polimerase immunohistochemical staining and the terminal deoxynucleotidyl transferase dUTP nick and labeling assay were used to determine the death of cells in both the monolayer and spheroid cultures.

Results:

An half maximal inhibitory concentration dose of silibinin in MDA-MB-231 and MCF-7 cells was 100 µM/mL at 24, 48, and 72 h of incubation. Terminal deoxynucleotidyl transferase dUTP nick and labeling positive cells and active poly-ADP-ribose-polimerase were detected after treatment with silibinin in both the monolayer and spheroid cultures. The dead cell count was higher in the MDA-MB-231 and MCF-7 cell lines with silibinin applied than in the controls.

Conclusions:

Our study demonstrated that silibinin applications enhanced terminal deoxynucleotidyl transferase dUTP nick and labeling positive cells and active poly-ADP-ribose-polimerase in comparison to the control in both the monolayer and spheroid cultures.