Setas (Turkey)

Introduction & Objective: Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT), with limited treatment options for steroid-resistant cases. Ruxolitinib, a JAK1/2 inhibitor, has shown promise in treating steroid-resistant acute (aGVHD), chronic (cGVHD), and overlap GVHD (oGVHD), but real-world data remain limited. This study evaluated the real-world efficacy and safety of ruxolitinib in allo-HSCT patients with steroid-resistant GVHD. Materials & Methods: This retrospective, multicenter study included adult patients treated with ruxolitinib for Grade II or higher aGVHD or moderate-to-severe cGVHD at nine centers in Turkey (2017-2024). Clinical characteristics, treatment responses, and adverse events were recorded. Primary outcomes were overall response rate (ORR) and overall survival (OS). Results: Among 80 patients (mean age: 39.3 ± 13.3 years; 60 males), 39 had aGVHD, 68 cGVHD, and 15 oGVHD. The ORR was 72 of 80 patients (90.0%) (complete response: 37 of 80 [46.3%], partial response: 35 of 80 [43.8%]). The 1-year and 2-year OS rates were 91.3% and 82.5%. Severe cGVHD (p < 0.001) and lack of response to ruxolitinib (p = 0.018) were associated with reduced OS. Adverse events included infections in 40 of 80 patients (50.0%), cytopenias in 23 of 80 (28.7%), and cytomegalovirus reactivation in 20 of 80 (25.0%). Conclusion: In this retrospective multicenter cohort, ruxolitinib was associated with high response rates in steroid-refractory GVHD, while disease severity remained a key determinant of survival, and findings should be interpreted as exploratory.

and low lupus awareness among non-specialists.The findings provided a clear mandate for more responsive, holistic lupus services.Conclusions The 2025 report's recommendations informed national service management plans, supported by the Musculoskeletal (MSK) Strategic Clinical Network.Impacts include: 1.A new practice of rheumatology clinicians writing directly to patients; 2. Plans for a regular rheumatology and renal MDT; and 3. Improved awareness and access to Psychology services.Patient representative feedback suggests that the evaluation has validated the emotional impact of the disease, but this will need to be translated into tangible improvements in care.This evaluation highlights the value of co-production between clinicians, researchers, and patient organisations in helping to improve patient care and outcomes.

Abstract Objective: Tumor recurrence remains a major clinical challenge among patients with low-risk non-muscle invasive bladder cancer (NMIBC). Molecular studies have identified two main subtypes with distinct genetic pathways: papillary, low-grade tumors often associated with FGFR3 mutations and favorable outcomes, and nonpapillary, high-grade tumors characterized by high progression and muscle invasion rates. This study aims to evaluate the predictive value of immunohistochemical (IHC) markers—CD44, CK5/6, CK20, GATA3 , Cerb-B2, ELF-3, and TSC-1—for recurrence in patients with low-risk NMIBC. Materials and Methods: This retrospective study included 40 patients with NMIBC selected from 320 individuals who underwent transurethral resection of bladder tumors (TUR-BT) between 2011 and 2019. Patients were categorized into recurrence ( n = 20) and nonrecurrence ( n = 20) groups. Tissues were reevaluated and stained for CK4, CK5/6, CK20, CD44, GATA3 , Cerb-B2, ELF-3, and TSC-1 using IHC methods. Associations between clinicopathological variables and recurrence were statistically analyzed. Results: Recurrence correlated significantly with tumor number ( p = 0.036 ), while age, sex, smoking status, and tumor size showed no significant association ( p &gt; 0.05). CD44 positivity was predominantly observed in nonrecurrent cases ( p = 0.022 ), whereas TSC-1 positivity was strongly associated with recurrence ( p = 0.003 ). Multivariate regression revealed that CD44 positivity reduced the recurrence risk (OR = 0.142), while TSC-1 positivity increased it more than 21-fold (OR = 21.871). Tumors located at the ureteral orifice exhibited a lower recurrence risk (OR = 0.098). Conclusion: This study indicates that low CD44 expression and high TSC-1 expression in patients with low-risk NMIBC may serve as predictors of tumor recurrence. Assessment of these markers could enable earlier identification of patients at increased risk, thereby facilitating strict surveillance and timely management of treatment strategies.

Bu çalışmada, intraserebroventriküler apelin-13 enjeksiyonunun kan basıncı, kalp hızı, kardiyak kontraktilite ve kardiyak sirtuin 1 (SIRT1) düzeyi üzerindeki etkilerini araştırdık. Apelin-13 (5, 10 ve 20 nmol) veya 10 µl salin, Wistar sıçanlarına intraserebroventriküler olarak enjekte edildi. İlk olarak, ortalama arteriyel kan basıncı (MABP) ve kalp hızı ölçüldü. İkinci olarak sol ventrikül ±dP/dt değerleri belirlendi. Son olarak sıçanların kalpleri çıkarıldı ve kalp dokularındaki SIRT1 seviyesi Western Blot yöntemi ile belirlendi. 10 nmol dozundaki apelin-13 MABP'yi artırdı. Bununla birlikte, 20 nmol dozundaki apelin-13 MABP'yi azalttı. 5 ve 10 nmol dozlarındaki apelin-13 kalp hızını azalttı. Bununla birlikte, 20 nmol dozundaki apelin-13 kalp hızını artırdı. 10 ve 20 nmol dozlarında apelin-13 +dP/dt değerlerini artırdı. 20 nmol dozunda apelin-13 –dP/dt değerlerini artırdı. 5 nmol dozundaki apelin-13, kalp dokularındaki SIRT1 düzeyini artırdı. Bu bulgular, apelinin kan basıncının, kalp hızının ve kardiyak kontraktilitenin merkezi düzenlemesine katıldığı gerçeğini desteklemektedir. Bu çalışma, apelinin santral uygulamasının sol ventrikül kontraktil performansını artırdığını göstermektedir. Ayrıca bu çalışma, SIRT1'in apelinin kardiyovasküler fizyolojik etkilerinde rol oynayabileceğine işaret etmektedir.

Acute kidney injury is a common complication of cardiac surgery, and factors such as advanced age, diabetes mellitus, and low left ventricular function are reported to be risk factors for the development of acute kidney injury after coronary artery bypass grafting (CABG). There are few studies in the literature reporting the relationship between preoperative low T3 syndrome and cardiac surgery-related acute kidney injury. In this study, ı aimed to evaluate the effect of preoperative free T3 levels on early postoperative kidney injury based on glomerular filtration rate and acute kidney injury development in isolated elective on-pump coronary artery bypass grafting patients. The study was conducted in our hospital on patients who underwent isolated elective on-pump CABG surgery. Patients who underwent other open-heart surgery other than CABG, patients who had previously undergone open-heart surgery, patients who underwent off-pump CABG, patients with known preoperative renal failure, patients with known thyroid disease, and patients for whom the study data were not available were excluded. Finally, a total of 183 patients included in this study were examined and compared in two groups according to their preoperative fT3 levels. The mean preoperative fT3 value was 2.06 ± 0.74 in Group 1 and 2.93 ± 0.53 in Group 2 (p = 0,000). The preoperative glomerular filtration rate value was 86.36 ± 11.16 and 88.78 ± 15.79 in Group 1 and Group 2, respectively (p = 0.150). Preoperative Hgb, diabetes mellitus, and age data were similar in both groups (p = 0.487, p = 0.936, and p = 0.073, respectively). The mean glomerular filtration rate change ratio (postoperative/preoperative glomerular filtration rate) was 0.93 ± 0.13 and 1.05 ± 0.56 (p = 0.437) for Groups 1 and 2, respectively. As a conclusion, according to the results of this study, no association was found between preoperative low fT3 and the development of postoperative acute kidney injury in on-pump coronary artery bypass grafting patients. However, we believe that further prospective studies with larger patient numbers would be beneficial to investigate the relationship between specific thyroid hormone disorders and the development of acute kidney injury after coronary artery bypass grafting.

To determine how storage medium and temperature affect the histological viability of autologous septal cartilage intended for early revision rhinoplasty. Cartilage specimens stored for 6 and 12 months in four media-dry, gentamicin, cefazolin, and saline-at two distinct temperatures underwent histopathological evaluation after paraffin embedding. The assessed parameters were graft viability, fibrosis, osteoid metaplasia, and peripheral chondroid proliferation. Among 480 septal cartilage specimens harvested from 30 patients, overall viability fell from 62 ± 15% at 6 months to 44 ± 14% at 12 months (p < 0.001), while fibrosis, osteoid metaplasia, and peripheral chondroid proliferation all increased significantly (each p < 0.001). Viability declined in every storage condition, but grafts kept at - 80°C or in saline-based solutions deteriorated fastest, reaching a mean viability of 39% versus 53% for dry storage at - 20°C at 12 months. Multivariate analysis confirmed - 80°C storage (OR 2.3, 95% CI 1.4-3.8) and saline media (OR 1.9, 1.1-3.4) as independent predictors of poor viability (< 40%), whereas antibiotic additives were not protective. Histological evidence of osteoid metaplasia (OR 3.6, 1.9-6.8) and peripheral chondroid proliferation (OR 2.1, 1.2-3.7) strongly predicted non-viable grafts. A linear mixed-effects model demonstrated additive negative effects of - 80°C and saline on both baseline viability and its rate of decline (marginal R² = 0.52). Dry storage at - 20°C yielded the most favorable long-term viability. Dry storage of autologous septal cartilage at - 20°C preserves graft viability well enough to offer a cost-effective alternative for early revision surgeries, warranting confirmation in prospective clinical trials.

Abstract Background The peach flat-headed rootborer, Capnodis tenebrionis Linnaeus (Coleoptera: Buprestidae), is an important pest of stone fruit. The adult females lay eggs on the stem near the root collar of the plant or 2 cm deep in the soil. The egg stage lasts approximately 8–12 days. The larvae hatch from the egg, quickly penetrate the plant tissue, and damage the roots. The adults damage the upper parts of the plant. Entomopathogenic fungi (EPF) are among the biological control agents used in pest control methods in recent years. The egg stage of C. tenebrionis is the most exposed stage to local EPF isolates as it occurs mainly in the soil. In this study, the efficacy of eight local EPF isolates, Metarhizium anisopliae (C7, C5, No. 1, and C2), Trichoderma harzianum (C11), Beauveria bassiana (C8), and Clonostachys rosea (C10), was tested against the egg stage of C. tenebrionis . The study was conducted in Malatya (Türkiye) in 2022. Results Metarhizium anisopliae (C7) had the highest efficacy, achieving C. tenebrionis egg mortality rate of 89.5%. Other effective strains included M. anisopliae (C5) (78.95%) and M. anisopliae (No. 1) (73.68%). Lower, yet notable, effects were found in M. anisopliae (C2) and T. harzianum (C11) with mortality rates of 57.89 and 47.37%, respectively. Less effective isolates, such as B. bassiana (C8) and C. rosea (C10), showed minimal mortality rates, indicating a lesser potential for pest control. Conclusions The findings suggest that the isolates of M. anisopliae have ovicidal activity against C. tenebrionis and are promising for the control of the pest. This practice can be integrated into sustainable pest control methods after being supported by field studies.

In this study, the milling behavior of AISI D2 cold work tool steel was experimentally investigated on a CNC vertical machining center. The aim was to optimize surface roughness through the Taguchi L18 orthogonal array design, considering the effects of cooling method, spindle speed, feed rate, and depth of cut. A total of 18 experiments were conducted under both wet and dry machining conditions. The results revealed that the use of coolant generally led to higher roughness values compared to dry machining. Statistical analysis using signal-to-noise (S/N) ratios and analysis of variance (ANOVA) showed that coolant application had the highest impact on surface roughness with a contribution rate of 47.04%, followed by spindle speed (27.99%), feed rate (8.05%), and depth of cut (4.66%). Regression models were developed to predict surface roughness, achieving a high correlation with experimental values (R² = 0.90). Confirmation experiments verified the optimization, with the optimal parameter combination (dry machining, 4000 rpm, 750 mm/min feed rate, and 0.10 mm depth of cut) reducing the average surface roughness from 1.08 μm to 0.37 μm, corresponding to a 65.7% improvement. Additionally, quality loss analysis indicated that losses were minimized by nearly 88.3% under optimized conditions. The results indicate that surface roughness values obtained under dry machining conditions were lower than those achieved using coolant in the milling of AISI D2 tool steel.

A 22-year-old homosexual male, newly diagnosed with human immunodeficiecy virus (HIV), presented with a rash and thin, scaly peeling on both knees and elbows. Multiple orange-brown, scaly plaques were observed on the flexor surface of the elbows. Histopathologic examination was consistent with a clinical diagnosis of pityriasis rubra pilaris (PRP). The CD4+ T lymphocyte count was 522/µL, and the viral load was 19,100 copies/µL. Treatment with acitretin and antiretroviral therapy was initiated, and the patient responded well within three months.