Determining anatomical localizations of cervical esophagus, hiatal clamp and esophagogastric junction with esophagogastroduodenoscopy

BACKGROUND

In this study, the purpose was to determine the anatomical localizations of the cervical esophagus length, hiatal clamp, and esophagogastric junction depending on age and gender in patients who undergo Esophagogastroduodenoscopy (EGD).

MATERIALS AND METHODS

The images of the patients who underwent EGD between 2018 and 2020 were analyzed retrospectively in this study. The distance of the anatomical localizations of the cervical esophagus length, hiatal clamp, and esophagogastric junction to the anterior incisors, and the relations of this distance with the demographic characteristics and clinical manifestations of the patients were investigated on the esophagogastroduodenoscopy data.

RESULTS

A total of 298 patients (174 women/124 men) were included in the study. The cervical esophagus length and the distance of the esophagogastric junction and hiatal clamp localization of the patients were found to be 15.06±0.57 cm, 37.51±2.23 cm and 38.62±2.23 cm, respectively. It was also found that the mean values ​​of all lengths in males were higher at a statistically significant level than in females (p<0.001; p<0.01).

CONCLUSIONS

Knowing these anatomical localizations may be important in predicting complications that may occur in this region in EGD and planning the precautions to be taken. We also believe that it will guide clinicians in determining hiatal hernia and related deficiencies.

New Perspective on chronic functional constipation in children with the identification of the microbiota

Chronic functional constipation is a common gastrointestinal disorder in children with no underlying organic cause. Although reasons such as bad eating habits and early transition to solid food are blamed for constipation, the etiology of the disease has not been fully elucidated. Our study aims to determine the differences in stool microbiota between children with chronic functional constipation and healthy children. Feces samples of 49 patients and 40 healthy children who meet Rome IV criteria were analyzed by 16s rRNA /PCR (Polymerase Chain Reaction) method. Within the sample microbial diversity, the Shannon diversity index was calculated based on the profiles obtained using the R 2.15.2 software package programe. In our study, no statistically significant difference was found between the study group and the control group in terms of the Shannon Diversity Index (p <0.05). The species found in healthy children (n = 34) but not in constipated children were determined as Lactobacillus kefiri and Bifidobacterium infantis. In addition, Lactobacillus casei and Lactobacillus acidophilus were detected with a higher rate in constipated children (p> 0.005). Although there is no significant difference between microbiota subtypes, the fact that Lactobacillus kefiri and Bifidobacterium infantis were detected only in healthy children may guide the supportive treatments to be given to constipated children. The results of our study also show that there is a need for more comprehensive studies in large populations, supporting other literature studies showing that the gastrointestinal microbiota is different in constipated and normal children.

Coexistence of phylloides tumour and invasive ductal cancer in the breast

Phylloides tumor in the breast is a rare fibroepithelial tumor, which is often seen in young adult women. Phylloides tumor of the breast accounts for about 1% of all breast tumors and approximately 3% of all fibroepithelial tumors. Pre-operative diagnosis is difficult. Since there aren't any specific mammography and ultrasound findings, they cannot be distinguished from fibroadenomas through these imaging methods and are mostly followed up as if they are fibroadenomas. Patients often present with the complaint of a mass that has been present for a long time and had started to grow suddenly. The primary preferred approach for treatment is wide local excision with negative surgical margins. Coexistence of invasive ductal carcinoma with phylloides tumor in the same breast is a very rare occurrence. We present in this article, a 42-year-old female patient with an invasive ductal carcinoma inside a phylloides tumor in the same breast.

Effect of ohmic cooking followed by an infrared cooking method on lipid oxidation and formation of polycylic aromatic hydrocarbons (PAH) of beef muscle

In this study, the effects of ohmic cooking alone and a consecutive application of ohmic and infrared cooking on lipid oxidation and polycyclic aromatic hydrocarbon (PAH) formation in beef was investigated. In consecutive cooking, samples were first cooked ohmically at 40, 55 and 70 Volt for 7 minutes, then infrared cooking was applied to each side of ohmically cooked beef samples at 3 different temperatures (325, 375 and 425 °F) for 3 minutes. The thiobarbituric acid reactive substance (TBARS) levels of the samples were found between 0.31 and 1.74 mg MDA/kg. Increasing the voltage level in ohmic cooking caused a significant (P < 0.05) increase in the TBARS value. In the consecutive application of ohmic and infrared cooking, infrared cooking temperature caused a significant (P < 0.05) increase in the TBARS value at the same voltage levels. In this study, working with 40 and 55 Volts for ohmic cooking alone and 40 V-325 °F, 40V-375 °F settings for ohmic-infrared cooking gave a generally acceptable threshold level for TBARS value (1 mg/kg). About 12 polycyclic aromatic hydrocarbons (PAHs) were detected in the cooked beef by ultra-performance liquid chromatography fluorescence detector (UPLC-FD). Benzo(a)pyrene (BaP), which is the most common PAH, was detected at between 1.2514 and 1.4392 μg/kg and 4 PAH (sum of Benzo(a)pyrene, Chrysene, Benz(a)anthracene, Benz(b)fluoranthene) levels were detected at between 1.2514- 3.7844 μg/kg. The results of PAHs were reasonably below the European Commission regulation limits, which are very important and indicate that the cooking processes applied in this study are safe.

Internet use patterns and Internet addiction in children and adolescents with obesity

BACKGROUND

There are no data regarding the Internet addiction (IA) rates and patterns in youth with obesity.

OBJECTIVE

This study aimed to explore the prevalence and patterns of IA in children and adolescents with obesity. The relationship between IA and body mass index (BMI) was also investigated.

METHODS

Study includes 437 children and adolescents with age ranging from 8 to 17 years: 268 with obesity and 169 with healthy controls. The Internet addiction scale (IAS) form was administered to all participants. The obesity group also completed a personal information form including Internet usage habits and goals. Linear regression analysis was utilized to assess the contributions of Internet use habits and goals to BMI in the obesity group and IAS scores to BMI in both groups.

RESULTS

A total of 24.6% of the obese children and adolescents were diagnosed with IA according to IAS, while 11.2% of healthy peers had IA (p < 0.05). The mean IAS scores for the obesity group and the control group were 53.71 ± 25.04 and 43.42 ± 17.36, respectively (p < 0.05). The IAS scores (t = 3.105) and spending time more than 21 h week^-1 on the Internet (t = 3.262) were significantly associated with increased BMI in the obesity group (p < 0.05). Other Internet habits and goals were not associated with BMI (p > 0.05). The IAS scores (t = 8.719) were also found to be associated with increased BMI in the control group (p < 0.05).

CONCLUSIONS

The present study suggests that obese children and adolescents were found to have higher IA rates than their healthy peers, and the results indicate an association between IA and BMI.

The royal road to the obesity: A case report of food addiction

Increasing prevalence of obesity in the world and increasing role of processed foods in daily life has led to become the focal point of food addiction. In recent years, the animal studies and human brain imaging studies demonstrated the neurobiological and behavioral similarities between drug addiction and food addiction. Here, we aim to present a 13-year-old, female, adolescent who applied with complaints of anger and irritability and shows serious addictive behaviors of chocolate. Our patient with increasing chocolate consumption in the last two years was using atomoxetine 60 mg/day with attention deficit hyperactivity disorder (ADHD). She gradually needs more chocolate to be satisfied. She has complained of nervousness, irritability and serious chocolate-seeking behavior during chocolate deprivation. She gained weight in proportion to the increase in chocolate consumption. Her daily diet was increasingly deteriorated. We used behavioral approach and sertraline in her treatment and were observed that partially benefit from treatment. Combined data from retrospective accounts of adults and prospective observations of youth indicates that juveniles with ADHD are at increased risk for cigarette smoking and substance abuse and behavioral addiction such as Internet addiction, gambling and sex addiction during adolescence. Recognition of the food addiction is important to fight against obesity, strengthening the treatment of choice in the food addiction and take political measures against food addiction are becoming inevitable.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Effects of Temperature, Humidity and Additives on the Formation of Biogenic Amines in Sucuk during Ripening and Storage Periods

The effects of temperature (20, 30 and 40 C), humidity (50, 65 and 80% RH) and additives on the formation of biogenic amines (tryptamine, -phenyl ethylamine, putrescine, cadaverine, histamine, 1,7-diamino heptane, serotonin, tyramine, spermidine and spermine) in sucuk (Turkish dry-fermented sausage) were studied during ripening and storage periods. Cadaverine was not detected in any sausage. Tryptamine, -phenyl ethylamine, 1,7-diamino heptane, serotonin, spermidine and spermine were the minor biogenic amines found in sucuk. The formation of tryptamine, -phenyl ethylamine, histamine, 1,7-diamino heptane and spermidine were affected significantly (P<0.05) by temperature and% RH during the storage. Preservatives had also a significant effect (P<0.05) on the formation of biogenic amines. The lowest putrescine formation was observed in sucuk type containing the highest amount of additives after 60 days of storage, whereas the highest putrescine formation was obtained in the control sucuk made without additives. Histamine concentration ranged from 0.0 to 242.2 mg/kg and 0.0 to 135.8 mg/kg during ripening and storage periods, respectively. In general, tryptamine formation increased during ripening and decreased during the storage periods. Temperature and% RH of the storage might be used as hurdle factors to control the formation of biogenic amines in sucuk.

Thermal inactivation kinetics of hepatitis A virus in homogenized clam meat (Mercenaria mercenaria)

AIMS

Epidemiological evidence suggests that hepatitis A virus (HAV) is the most common pathogen transmitted by bivalve molluscs such as clams, cockles, mussels and oysters. This study aimed to generate thermal inactivation kinetics for HAV as a first step to design adequate thermal processes to control clam-associated HAV outbreaks.

METHODS AND RESULTS

Survivor curves and thermal death curves were generated for different treatment times (0-6 min) at different temperatures (50-72°C) and Weibull and first-order models were compared. D-values for HAV ranged from 47·37 ± 1·23 to 1·55 ± 0·12 min for the first-order model and 64·43 ± 3·47 to 1·25 ± 0·45 min for the Weibull model at temperatures from 50 to 72°C. z-Values for HAV in clams were 12·97 ± 0·59°C and 14·83 ± 0·0·28°C using the Weibull and first-order model respectively. The calculated activation energies for the first-order and Weibull model were 145 and 170 kJ mole(-1) respectively.

CONCLUSION

The Weibull model described the thermal inactivation behaviour of HAV better than the first-order model.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides novel and precise information on thermal inactivation kinetics of HAV in homogenized clams. This will enable reliable thermal process calculations for HAV inactivation in clams and closely related seafood.

Increased serum levels of GDF-15 associated with mortality and subclinical atherosclerosis in patients on maintenance hemodialysis

BACKGROUND/AIMS

Increased carotid intima-media thickness (CIMT) was shown to be an independent predictor of cardiovascular (CV) mortality in dialysis patients and the general population. Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor superfamily, is produced by cardiomyocytes and atherosclerotic lesions under stress conditions such as inflammation. We assessed associations between serum concentrations of GDF-15, mortality, and CIMT for subclinical atherosclerosis in hemodialysis (HD) patients.

METHODS

A total of 87 patients on maintenance hemodialysis and 45 sex- and age-matched healthy controls were included in this prospective study. Serum GDF-15 levels were measured by ELISA. CIMT was assessed by Doppler ultrasonography. The association between serum GDF-15 levels and mortality was assessed using Cox regression analysis with serum levels categorized into two groups according to the median value (328.18 pg/ml). Patients were followed for 2 years and cause-specific and all-cause mortality were determined.

RESULTS

The median level of serum GDF-15 was significantly higher in HD patients than controls [328 (198-522) vs. 176 (101-289) pg/ml, p < 0.01, respectively]. Serum GDF-15 levels were correlated to CIMT (r = 0.607, p < 0.001), C-reactive protein (CRP; r = 0.250, p = 0.010), HD duration (r = 0.376, p = 0.004), and serum albumin (r = - 0.156, p = 0.030). The multivariate analysis revealed that GDF-15 was found to be an independent variable of CIMT in HD patients. In the study, the serum GDF-15 level was an independent marker of all-cause of mortality when adjusted for age, CRP, and history of diabetes mellitus.

CONCLUSION

The relationship between serum GDF-15, mortality, and carotid artery thickening suggests that GDF-15 may be a novel marker of atherosclerosis, inflammation, and malnutrition in HD patients.

Cervical lymphadenitis: tuberculosis or tularaemia?

Both tuberculosis cervical lymphadenitis (TCL) and oropharyngeal tularaemia (OT) have similar signs, symptoms and pathological findings. We aimed to investigate the frequency of tularaemia antibodies in patients diagnosed with TCL. Using data from the Tuberculosis Control Dispensaries between the years of 2008 and 2011 in Turkey, all patients diagnosed with TCL were informed about and included in the study. Control group subjects were selected from healthy blood donors who lived in the same region. After informed consent was obtained, the sera obtained from volunteer TCL patients and the control group were tested with a microagglutination technique for Francisella tularensis. Antibodies to Brucella were also investigated with a tube agglutination test for cross-reactivity in sera that were seropositive for tularaemia. Sera were obtained from a total of 1170 individuals in the TCL group and 596 in the control group from 67 of 81 provinces in Turkey. Francisella tularensis-positive antibodies were found in 79 (6.75%) cases in the TCL group and two (0.33%) cases in the control group with a titre of ≥1:80 (p < 0.01). When the presence of antibody of any titre was considered, the ratio became 8.2% (96/1170) in the TCL group and 0.67% (4/596) in the control group (p < 0.001). For the first time, with this study, tularaemia serology was found to be positive in a significant portion (6.75%) of diagnosed cases of TCL. In tularaemia endemic regions, it was concluded that tularaemia serology should be investigated in patients suspected of having TCL.

Ohmic and Conventional Heating of Pomegranate Juice: Effects on Rheology, Color, and Total Phenolics

Ohmic heating is an alternative fast-heating method especially for liquid foods. In this study, pomegranate juice samples, prepared by two different extraction methods, were heated ohmically by matching the same thermal history, with that of the conventional method. The ohmic heating application was conducted by changing the voltage gradient (10—40 V/cm) at 50 Hz. The samples were heated from 20 ° C to 90°C and held at 90 °C for different treatment times (0, 3, 6, 9 or 12 min). Although rheological properties, color, and total phenolic content (TPC) values changed at the initial heating up period, there were no significant changes during holding period (p < 0.05). Non-Newtonian (power law) rheology model had higher regression coefficient than Newtonian model, and the extraction method affected the consistency of pomegranate juice samples (p < 0.05). Color values of juice extracted from arils (APJ) was better than that of juice extracted from whole fruits (PPJ), as PPJ contained higher amount of TPC (p < 0.05). Since the heating method did not affect the rheological properties, color, and TPC values, it could be said that there was no electrical effect rather than thermal effects during ohmic heating of pomegranate juice. Ohmic heating could be recommended as an alternative fast-heating method for fruit juices.

Distribution, optimum detection time and antimicrobial susceptibility rates of the microorganisms isolated from blood cultures over a 4-year time period in a Turkish university hospital and a review of the international literature

This study retrospectively examined 8986 blood cultures from patients over a 4-year time period in an eastern Turkish university hospital to determine the detection times and distribution of isolated microorganisms using the automated BACTEC 9050 and BACTEC 9120 systems. A total of 1914 (21.3%) blood cultures contained pathogenic microorganisms and 252 (2.8%) positive cultures were considered contaminated. Of all the cultures, 18 (0.2%) were false positives and 224 (2.5%) were false negatives. In cultures containing pathogenic microorganisms, Gram-positive and Gram-negative bacterial isolation rates were 436 (22.8%) and 1440 (75.2%), respectively, and yeasts (all Candida sp.) were found in 38 (2.0%) cultures. Coagulase-negative staphylococci occurred in 936 (48.9%) cultures and Staphylococcus aureus occurred in 302 (15.8%) cultures. The mean detection time for all of the pathogens was 21 h and Brucella spp were isolated within 10 days. This study helps in understanding the epidemiology of the region and in providing positive therapeutic approaches. A review of the international literature helps to place this understanding into a global context.

Correlation of Slime Production Investigated via Three Different Methods in Coagulase-Negative Staphylococci with Crystal Violet Reaction and Antimicrobial Resistance

This study investigated slime production by coagulase-negative staphylococci (CNS) using the standard tube (ST), Congo red agar (CRA) plate and Christensen's tube (CT) methods, and compared the results with those of the crystal violet reaction (CVR) test. The potential correlation between slime production and antimicrobial resistance was also evaluated. In total, 205 CNS strains were isolated from biological samples: 92 (44.9%) were shown to produce slime by the ST method; 96 (46.8%) by the CRA plate method; 90 (43.9%) by the CT method; and 89 (43.4%) strains were CVR positive. Eighty-three (40.5%) CNS strains were positive for slime production by the ST, CRA and CT methods. The findings of the ST, CRA and CT test methods were consistent with each other but were not related to CVR positivity. Based on the ST method, rates of antibiotic resistance to several antimicrobial agents were higher in slime-positive strains than in slime-negative strains and, in some cases, this was statistically significant.

Change in serum concentrations of interleukin-2 and interferon-gamma during treatment of tuberculosis

We aimed to investigate changes in serum concentrations of the cytokines interleukin (IL)-2 and interferon (IFN)-gamma during the clinical course of active tuberculosis, to establish the presence of cellular immunity before and after treatment. Blood samples were taken from 18 patients with active tuberculosis before and 2 months after therapy; IL-2 and IFN-gamma concentrations were evaluated. The mean serum IL-2 concentration before therapy was 164.5 pg/ml (range 12-980 pg/ml) and the concentration 2 months after therapy was 92.11 pg/ml (range 1-490 pg/ml). The mean serum IFN-gamma concentrations were 10.83 pg/ml (range 1-22.2 pg/ml) and 4.64 pg/ml (range 1-28.5 pg/ml), respectively. The decrease in concentrations of both cytokines after therapy was statistically significant. Further studies investigating the benefits of adding cytokines to drug treatment for tuberculosis are needed.

Tinea capitis in Van, Turkey

Forty patients with an average age of 6.5 +/- 3.2 years (28 male 12 female) who applied to the YYU Medical Faculty Dermatology Department outpatient clinic were investigated. Tinea capitis profunda was determined as the most frequent clinical type. The isolated dermatophytic flora of the patients consisted of Trichophyton verrucosum (43%), T. violaceum (30%), T. rubrum (23%) and T. mentagrophytes (3%). The patients with tinea capitis profunda were mostly from rural areas.

Epidemiological analysis of Staphylococcus aureus strains from nasal carriers in a teaching hospital

The present study was conducted to assess the epidemiological relation of Staphylococcus aureus isolates from nasal carriers of hospital staff. Nasal swabs were taken from each of 327 personnel. After culturing on blood agar for overnight, probable staphylococcal isolates were identified and subjected to tube coagulase test. After a two-week interval, second nasal swabs were taken from the subjects whose first cultures were positive for S. aureus. Nasal carriage was defined in 58 (17.7%) personnel with positive culture for both sampling time. Antibiogram typing and arbitrarily-primed polymerase chain reaction (AP-PCR) with M13 primer were used for typing of the strains. Antibiotyping distinguished seven types and three subtypes, and 85% of the isolates were clustered in one group. AP-PCR, in contrast, identified 12 distinct patterns with 13 variants. A specific profile was not found among the isolates obtained from the personnel in a particular clinic. These results indicate that antibiotyping has poor discrimination power and heterogeneity among the nasal S. aureus strains in the hospital personnel screened is high.

Asymptomatic bacteriuria in infants in eastern Turkey

In this study, the prevalence of asymptomatic bacteriuria (ABU) was investigated in the 146 infants without symptoms suggesting urinary tract infection, age ranged from 29 days to 15 months (mean 4.56 +/- 3.30 months). Our purpose was to determine the prevalence ofABU in infants living in Eastern Turkey and to define the relationship between pyuria and ABU in infants. Of 146 infants, 77 (52.7%) were males, and 69 (47.3%) were females. Although we would like to select randomized healthy infants for the study, 47 (32.1%) infants had a mild to severe malnutrition. While various microorganisms were cultured in 41 (28%) infants in the first urinary culture, only 18 (12.3%) infants had a positive culture in the second urinary culture. The prevalence of ABU was 12.3%. Although ABU prevalence was higher in the infants with malnutrition than those without malnutrition (14.8% 1 vs. 11.1%), there was not a difference between the groups (p>0.05). There was a positive relation between urinary culture positiveness and pyuria (p < 0.001). The prevalence of ABU was much higher (12.3%) than the literature data, which was probably related to very low socioeconomic status of our region where malnutrition and its related disorders are commonly seen. The high ratio might also be related to the method of urine collection, because we used sterile collecting bag, but not suprapubic aspiration method.

The effect on survival of thoracic duct ligation in experimental peritonitis

BACKGROUND/AIMS

It has been shown that systemic bacteremia and endotoxemia in peritonitis is mainly related to lymphatic transport via the thoracic duct. This study was performed to investigate the effect on mortality of thoracic duct ligation in experimental peritonitis.

METHODOLOGY

Thirty dogs were divided into three groups. Groups I, II, and III were control, unligated, and ligated thoracic duct peritonitis groups, respectively. Liver biopsy, blood and peritoneal fluid cultures were taken and survival time was established.

RESULTS

Bacteria were determined in peritoneal fluid in all animals in groups II and III. Growing bacteria numbers in group III were two times higher than in group II. While bacterium was grown on blood cultures in all group II animals, growing was determined on blood cultures in only 2 animals in group III. Diffuse necrosis was determined in the liver of 2 animals who died within 72 hours in group II. Another 8 animals had minimal focal necrosis in their livers. Diffuse and progressive necrosis was determined in the liver of all animals in group III. The difference between liver necrosis in group II and group III was found to be statistically significant (p = 0.002).

CONCLUSIONS

This experimental study demonstrates that thoracic duct ligation decreases bacteremia rates clearly but that mortality increases significantly.