Introduction Ralstonia spp. are nonfermenting gram-negative bacteria that have recently emerged as opportunistic pathogens. Previously, two case series of infection associated with Ralstonia insidiosa have been published. In this case report, R. insidiosa infection of a neonate in the neonatal intensive care unit (NICU) is presented. Case Presentation A term male infant developed respiratory distress 2 hours after birth and was admitted to the NICU with the presumptive diagnosis of transient tachypnea of the newborn. A left apical pneumothorax was detected, requiring chest tube insertion. An umbilical catheter was placed due to poor peripheral vascular access. On the second day, blood cultures were sent from the umbilical artery and umbilical venous catheters, which showed growth of R. insidiosa. The antibiotics were changed from ampicillin and gentamicin to ampicillin–sulbactam and cefotaxime according to the antibiotic susceptibility test results. Respiratory distress symptoms resolved and the patient was extubated. The infant's clinical condition improved steadily and was discharged with breast feeding and stable vital findings, negative follow-up cultures, and C-reactive protein. Conclusion Ralstonia insidiosa is an emerging pathogen in hospital infections due to its ability to survive in water supplies and sterilized water-based solutions. There is need for vigilance of R. insidiosa, especially in intensive care units. Awareness of rare pathogens, early detection of the bacteria, and antibiotic susceptibility test results are important in the success of treatment.

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.

Bu çalışmanın amacı, Aralık 2019'dan beri tüm dünyayı etkisi altına alan koronavirüs salgını süresince Türk halkının sergilediği tutumu (bilişsel, duyuşsal ve davranışsal boyutlarda) ve bu tutum üzerinde etkili olan etmenleri belirlemektir. Gereç ve Yöntem:Bir ölçek aracılığı ile derlenen veriler açıklayıcı faktör analizi (AFA), doğrulayıcı faktör analizi (DFA), yapısal eşitlik modellemesi (YEM) ile modellenerek, boyutlar arası ilişkiler ile her bir boyutta etkili olan maddelerin önemleri belirlenmiştir. Bulgular: Katılımcıların %61,4'ü erkek ve %65,4'ü 40 yaş altıdır. Bireylerin tutumlarını açıklayan alt boyutlardan davranışsal boyut üzerinde bireylerin ekonomik tedbirlere vereceği önemin en etkili değişken olduğu, bilişsel ve duyuşsal boyutlarda ise sırası ile bireylerin hayata geliş amaçlarını tekrar ABSTRACT Aim: The aim of study is to determine the attitude of the Turkish people (in cognitive, affective and behavioral dimensions) and the factors affecting this attitude during the coronavirus epidemic that has affected the whole world since December 2019. Materials and Methods:The data collected by a scale were modeled with explanatory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM), and the effects of the dimensions and the importance of the effective items in each dimension were determined.Results: 61.4% of the participants were male and 65.4% were under the age of 40 years. Individuals' "questioning their purpose of coming to life again" and "desire of being more sensitive to the events around them than in the past" were found to be significant, respectively. Other results obtained from the study are given in the relevant tables and figures. Conclusion:It was determined that the affective dimension had the highest effect on the results of EFA, CFA and SEM analyses, which were effective in examining the attitudes of individuals towards an event with these sub-dimensions.

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Objective: The aim of this study was to evaluate the effects of vitamin K2 on fracture healing. Methods: Twenty-four 6-week-old male Wistar albino rats that had open tibia fractures induced were included in this study. They were divided into 2 groups of 12, a group that had vitamin K2 administered over 30 consecutive days and a control group. After 30 days, the rats were sacrificed, and from each group, 6 tibiae were selected for biomechanical testing to examine the mechanical strength of the callus tissue using the Instron 3-point bending test and 6 tibiae were selected for histological analysis to examine the density and organization of callus tissue using Allen’s grading system and Huo et al’s grading system. Furthermore, weekly x-rays were taken to evaluate bone union described by Lane and Sandhu, and osteocalcin, procollagen I N-terminal propeptide, and procollagen I C-terminal propeptide were examined in blood samples taken by intracardiac puncture during sacrification. Results: Breaking force ( P = .047), breaking time ( P = .019), stiffness ( P = .039), fracture strength ( P = .041), and Young’s modulus ( P = .032) showed a statistically significant increase in the K2 group. Procollagen I C-terminal propeptide ( P = .024), procollagen I N-terminal propeptide (.047), and osteocalcin (.048) levels were significantly higher in the K2 group compared to the control group. Furthermore, 3rd-week x-rays showed higher bone union scores according to the Lane and Sandhu method in the K2 group ( P = .014). However, the histological grading systems of Allen and Huo et al did not show statistically significant differences between groups ( P = .086, P = .07, respectively). Conclusion: In light of these findings, it could be concluded that vitamin K2 has a significant positive effect on fracture healing.

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Chylothorax is a rare condition characterized by accumulation of chylous fluid in the pleural space resulting in impaired ductus thoracic integrity. It can be an outcome of a traumatic process, although there are a few non-traumatic and/or idiopathic cases in current literature. In this article, we present the oldest case report so for, who is an 87-year-old woman complaining of acute respiratory distress symptoms with pleural effusion having no trauma history. The patient was analyzed for the disease etiology strenuously. Thoracentesis was performed together with imaging modalities and detailed systemic laboratory tests. Non-surgical treatment was successful as the outcome.