Utility of F-18 fluorodeoxyglucose pos?tron em?ss?on tomography/computed ?n carc?noma of unknown primary

Carcinoma of unknown primary (CUP) is a heterogeneous group of tumors with various clinical features causing diagnostic and therapeutic challenges. The aim of this study was to evaluate the ability of F-18 FDG PET/CT for localizing the primary tumor, disclosing additional metastases, and changing the treatment in patients with CUP. One hundred and twelve metastatic patients (female = 40, male = 72, median age = 60.5 years) in whom conventional diagnostic work-up failed to disclose the primary tumor were included in the study. F-18 FDG PET/CT imaging was performed in a standard protocol (patient supine, arms on patient’s side, vertex to thigh, 369.3 MBq (296-444 MBq) F-18 FDG, a 60-minute uptake period, 6-7 bed position). Histopathology was taken as the only reference standard. F-18 FDG PET/CT correctly detected primary tumor in 37 of 112 (33.03%) patients. The most common site of primary tumor detected by F-18 FDG PET/CT was lung (n = 18), which was followed by nasopharynx (n = 7), pancreas (n = 5), tonsil (n = 2), breast (n = 2), thyroid (n = 1), uterus (n = 1) and colon/rectum (n = 1). F-18 FDG PET/CT imaging disclosed additional previously undetected metastases in 32 (28.5%) and changed the treatment in 33 (29.4%) of 112 patients. There were false positive F-18 FDG PET/CT results in 21 (18.5%) patients. F-18 FDG PET/CT is able to disclose the primary tumor, disclose new metatases and change the treatment in about one third of patients with CUP.     

Drug dependence and its risk factors in emergency department patients: A retrospective cross-sectional study

Objective: To determine the characteristics and risk factors of drug dependence among patients who were administered drugs with addictive potential (DAP) in an emergency department (ED).Methods: This retrospective cross-sectional study included patients who were administered DAP 3 or more times in the emergency room between September 1, 2019 and March 1, 2020. The demographic and baseline information were recorded. All the prescibed DAP, the reasons to use these drugs, secondary drug dependence, the department where DAP were first prescribed, types of doctors who preferred to prescribed DAP, and the risk factors for the development of drug dependence were determined. Results: A total of 3000 patients were screened from medical records, and among them, 80 patients developed drug dependence. Drug dependence only developed for tramadol (n=57, 71.3％), diazepam (n=11, 13.8％), and biperiden (n=12, 15.0％). Tramadol was the most frequently prescribed drug (n=57, 71.3％). The most common reason for drug dependence was psychiatric disorders (n=29, 36.3％). Drug dependence developed in renal colic patients due to the administration of tramadol (n=7, 100％). On the contrary, dependence to biperiden were mainly developed in patients with psychiatric complaints (n=12, 41.4％). The rate of secondary drug dependence was 15％ (n=12). Of the Biperiden users, 41.7％ developed secondary drug dependence on diazepam. Most DAP were first prescribed in the ED (n=52, 65％), and the specialist preferred to prescribe DAP (n=43, 53.8％). For the development of dependence, the presence of renal colic (OR: 3.387, 95％ confidence interval (CI): 1.473-7.788, P=0.004) and low back pain (OR: 5.778, 95％ CI: 2.779-12.014, P<0.001) were the risk factors. Conclusions: Most DAP were first prescribed in the ED compared to other departments, and specialist are preferred to use DAP. Tramadol is the most commonly used drugs caused drug dependence. Psychiatric disorder patients are easier to develope drug dependence. Furthermore, renal colic and low back pain patients needs more attention to avert drug dependence.     

Production of chlorine-containing functional group doped graphene powders using Yucel's method as anode materials for Li-ion batteries

In this study, the one-step electrochemical preparation of chlorine doped and chlorine-oxygen containing functional group doped graphene-based powders was carried out by Yucel''s method, with the resultant materials used as anode materials for lithium (Li)-ion batteries. Cl atoms and ClO_x (x = 2, 3 or 4) groups, confirmed by X-ray photoelectron spectroscopy analysis, were covalently doped into the graphene powder network to increase the defect density in the graphene framework and improve the electrochemical performance of Li-ion batteries. The microscopic properties of the Cl-doped graphene powder were investigated by scanning electron microscopy and transmission electron microscopy (TEM) analyses. TEM analysis showed that the one-layer thickness of the graphene was approximately 0.33 nm. Raman spectroscopy analysis was carried out to determine the defect density of the graphene structures. The G peak obtained in the Raman spectra is related to the formation of sp² hybridized carbons in the graphene-based powders. The 2D peak seen in the spectra shows that the synthesized graphene-based powders have optically transparent structures. In addition, the number of sp² hybridized carbon rings was calculated to be 22, 19, and 38 for the Cl-GP1, Cl-GP2, and Cl-GOP samples, respectively. As a result of the charge/discharge tests of the electrodes as anodes in Li-ion batteries, Cl-GP2 exhibits the best electrochemical performance of 493 mA h g⁻¹ at a charge/discharge current density of 50 mA g⁻¹.

In this study, the one-step electrochemical preparation of chlorine doped and chlorine-oxygen containing functional group doped graphene-based powders was carried out by Yucel''s method, with the resultant materials used as anode materials for lithium (Li)-ion batteries.     

Insights into major facilitator superfamily domain-containing protein-2a (Mfsd2a) in physiology and pathophysiology. What do we know so far?

Major facilitator superfamily domain-containing protein-2a (Mfsd2a) which was considered as an orphan transporter has recently gained attention for its regulatory role in the maintenance of proper functioning of the blood–brain barrier. Besides the major role of Mfsd2a in maintaining the barrier function, increasing evidence has emerged with regard to the contributions of Mfsd2a to various biological processes such as transport, cell fusion, cell cycle, inflammation and regeneration, managing tumor growth, functioning of other organs with barrier functions or responses to injury. The purpose of this article is to review the different roles of Mfsd2a and its involvement in the physiological and pathophysiological processes primarily in the central nervous system and throughout the mammalian body under the lights of the current literature.     

When is the right time to take an emergency surgery decision in Mechanical Intestinal Obstruction?

Background/Objective: Ischemia is a leading cause of morbidity in Mechanical Intestinal Obstruction (MIO) in which the timing of decisions of whether to proceed to surgical or conservative treatment is critical in emergency departments (ED). While advanced technological options are available, patients may be negatively affected by the application of contrast agents or radiation. The use of ultrasound is limited because of the air in the intestines does not allow a good field of vision. While biomarkers can be considered as a good alternative option at this point. In the present study we examine the effect of hemogram and blood gas parameters on early surgical decision-making in MIO patients.MethodInvolved in this observational prospective study were 264 patients diagnosed with MIO who presented to the Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University between February 2018 and February 2019. Contrast-enhanced tomography (CECT) and laboratory results of the patients were recorded. Pathology reports of the patients who underwent surgery were collected. Laboratory data were analyzed by comparing CECT and pathology reports.ResultsIn a ROC analysis of the laboratory values of the patients who were diagnosed with ileus, the sensitivity was calculated as 80% and the specificity was 57.7 in values above WBC>10.75 (10⁹/L), 96.6%, and the specificity was 31.1% in N/L > 2.9. For intestinal ischemia, the cut-off values were WBC> 12.6 and N/L > 3.2, Lactate >2.8 mmol/L and B.E < -3.6 mmol/L.ConclusionDiagnoses of ileus are based on the results examinations and imaging methods. More data are needed to support decisions on the timing of surgery in ED. WBC, N/L, Lactate and Base Excess indicate an ischemic segment. When the parameters are evaluated together, they strongly support early surgical decision-making regarding the treatment of intestinal ischemia.     

Comparison of nasal mucociliary clearance in adenoid hypertrophy with or without otitis media with effusion

Objective

To investigate pre- and postoperative mucociliary clearance in patients with adenoid hypertrophy or combined with otitis media with effusion.

Methods

Patients were divided into two groups: Group 1—patients with adenoid hypertrophy (AH), and Group 2—patients with AH and otitis media with effusion (AHOME). In all patients, AH size was recorded, and the Andersen saccharin and methylene blue tests were conducted before and 1 month after surgery to obtain mucociliary clearance time (MCT). Nasal cavity length was measured intraoperatively to establish mucociliary clearance velocity (MCV). Patients with allergic rhinitis, active infection, and history of nasal or ear surgery were excluded.

Results

This study included 64 patients with a mean age of 8.34 ± 2.98 years (range: 3–18 years). Pre- and postoperative MCT were 14.60 ± 4.83 and 9.48 ± 2.63 min in Group 1 and 16.03 ± 4.31 and 12.12 ± 3.78 min in Group 2, respectively. Pre- and postoperative MCV were 0.77 ± 0.30 and 1.16 ± 0.42 mm/min in Group 1 and 0.67 ± 0.16 and 0.89 ± 0.28 mm/min in Group 2, respectively. MCT and MCV were significantly improved postoperatively in both groups (p < 0.001). In addition, the postoperative MCT and MCV of Group 1 were significantly better than those of Group 2 (p < 0.001). Exposure to cigarette smoking and adenoid size had negative correlations with mucociliary clearance.

Conclusions

Otitis media was associated with impaired mucociliary clearance and further studies should be performed to demonstrate the causes of this deficiency.     

Demonstration of false inclusion risks of duo parentage analyses in the Turkish population in light of parentage acceptance criteria

In routine parentage tests, trio analyses (father-mother-child) are preferred. Under certain circumstances, laboratories may have to perform duo analysis (without mother/father). However, duo analyses increase the risk of false inclusions. This paper aimed to evaluate the false inclusion risks of duo analyses in the Turkish population from the point of forensic applications and the Turkish judicial system. Children from 400 previously analysed cases were compared separately with fathers and mothers of other cases by using a computer programme. From the total 345,006 comparisons, in 16 comparisons, no Short Tandem Repeat (STR) mismatch was observed at 15 STR loci between the child and an unrelated parent. In other words, duo tests provided a coincidental second mother or father to 16 children. In almost all of these cases, the probabilities of paternity estimation values are greater than Turkish Judicial System’s parentage acceptance limit, which is 99.73%. According to results, we suggested that trio cases should be performed as much as possible and the parentage acceptance limit, which is 99.73%, should be re-evaluated by a law maker’s commission to prevent false inclusion parentage cases in Turkey.