Objective Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection might have a higher mortality rate in patients with end-stage renal disease due to immunosuppression. This study investigates the mortality rates of SARS-CoV-2 infection and the factors affecting mortality among patients who were on maintenance hemodialysis and continuous ambulatory peritoneal dialysis. Materials and methods A total of 200 patients, including 157 maintenance hemodialysis and 43 continuous ambulatory peritoneal dialysis patients followed in our hospital, were included in the study. The patients' sociodemographic characteristics, comorbidities, history of SARS-CoV-2 infection in the previous year, death event, source of death (SARS-CoV-2 or not), presence of hospitalization due to SARS-CoV-2 infection, need for intensive care unit, need for ventilatory support in intensive care unit were obtained from the clinical file records. Results 85 of the 200 patients had a history of SARS-Cov-2 infection during the last 12 months. Forty-two (49.5%) patients with SARS-CoV-2 infection were hospitalized. Patients with SARS-CoV-2 had longer dialysis time, increased mortality, and significantly higher comorbidities such as coronary artery disease, congestive heart failure. Besides, heart failure and hypertension were the determining factors in the risk factor analysis for SARS-CoV-2 infection. In dialysis patients, the mortality rate in the last year, due to all causes, including SARS-CoV-2 infection, was 23% while the mortality rate due to "SARS-CoV-2 infection only" was 13%) ( p > 0.05). Our findings are important in guiding clinical decision-making and informing the public and health authorities about the risk of death associated with COVID-19 in this patient group.

SummaryBackground: Recent studies have shown that the expression status of hormone receptors and human epidermal growth factor receptor 2 (HER2) in breast cancer may change during disease progression. The aim of this study was to determine and compare the estrogen receptor (ER), progesterone receptor (PR), and HER2 expression status in primary breast cancer and metastatic lesions. Methods: 58 patients with registered biopsy reports or available samples of the primary tumor and distant metastases were included in the final analysis. Biopsy samples were re-stained using immunohistochemical methods to determine receptor status (if not already recorded in previous reports) and re-examined by 2 independent pathologists. Results: Discordance rates for receptor expression status of the primary tumor and distant metastases for ER, PR, and HER2 were 17.4, 45.4, and 13.3%, respectively. No statistically significant difference in overall survival due to receptor expression discordance between the primary tumor and metastatic sites (p > 0.05) was found, although a tendency toward worse survival time was observed in patients with HER2 expression discrepancies. Conclusion: This study showed receptor discordance rates between primary and metastatic breast cancer sites for ER, PR, and HER2 of 17.8, 45.4, and 13.3%, respectively. Re-biopsy and IHC evaluation of metastatic sites for receptor status may change treatment decisions in patients with relapsed/progressed BC.

Background/aim: Deficient levels of vitamin D are an important factor in the pathogenesis of some neurodegenerative diseases. The aim of this study is to determine the relationship between vitamin D deficiency and depression status and sleep disorders of patients on dialysis. Materials and methods: In this cross-sectional study, 121 hemodialysis patients were enrolled. All patients had been on hemodialysis for at least six months at the time of the study. Sleep quality and depression status were measured by using specific inventories. All the patients filled out Pittsburg Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), and gave blood samples. Vitamin D levels were measured for 121 patients, and statistical analysis was done by using SPSS. Results: Regression analyses demonstrated that low levels of 25(OH)D and high BDI score were independent risk factors for poor sleep quality [ORs were 0.668 (0.566-0.789), 1.080 (1.001-1.164), and 1.080 (1.001-1.164), respectively]. Conclusion: Our results suggest that deficiency of 25(OH)D is an important independent risk factor for poor sleep quality in hemodialysis patients.

Primary cardiac osteosarcomas are uncommon tumors. They have an aggressive biology and hence poor prognosis. This report describes a 23-year-old male patient who was referred to our hospital with chest pain. Echocardiography showed a left atrial mass, and tumor excision revealed a cardiac osteosarcoma. Adjuvant cisplatin plus ifosfamide combination chemotherapy provided a disease-free survival of 9 months; unfortunately the patient died of metastatic disease thereafter.

The new coronavirus disease (COVID-19), which was detected in the Wuhan region of China in 2019 and spread rapidly all over the world, was declared a pandemic by the WHO in 2020. Since then, despite widespread recommendations to prevent the spread of the disease and provide treatment for sick people, 6,573,968 people died all over the world, 101,203 of which in Turkey. According to the international adult vaccination guidelines, pregnant women have been recommended to get vaccinated against the new coronavirus disease, as well as influenza and tetanus, during pregnancy. Before this study, not enough information was available about the vaccination awareness and vaccination hesitancy rates of pregnant women living in Turkey. For this reason, we believe that our study will contribute to filling this gap in the literature. The main objective of this study was to investigate the vaccination rates of pregnant women in a local hospital in Turkey and the reasons for vaccine hesitancy in this patient group. The minimum sample size of the study was found to be 241, with 80% power, 0.2 effect size, and 95% confidence interval, at p < 0.05 significance level. We included 247 consecutive pregnant women who applied to the Samsun Training and Research Hospital Gynecology and Obstetrics Outpatient Clinics between January 2022 and April 2022. The researchers prepared a questionnaire by taking into account the characteristics of the local community. A preliminary survey with these questions was also conducted before starting the main study. The mean age of the pregnant women participating in the study was 28.7 ± 5.3 years, and the mean gestational age was 28.2 ± 7.9 weeks. Among the participants, 26.3% were university graduates or had a higher degree, and 17% were actively working; in addition, 93 (37.7%) of the 247 pregnant women had received the COVID-19 vaccine, 203 (82.2%) had received at least one dose of the tetanus vaccine, and only 1 (0.4%) person had been administered the influenza vaccine during pregnancy. The most common reason for COVID-19 vaccine refusal and hesitancy was safety concerns, while the low rates of tetanus and influenza vaccination were due to a lack of knowledge. These results show that it is important to inform and educate the pregnant population on this subject to improve their vaccination behavior.

Background/Aim: Diabetic retinopathy is a common ailment that causes visual impairment among adults, and evidence suggests that oxidative stress plays a significant role in its pathogenesis. The objective of this study was to examine the potential association between selenium deficiency and an increased risk of diabetic retinopathy among individuals with type 2 diabetes mellitus. Methods: This study was a prospective case-control study. 115 patients with a diagnosis of type 2 diabetes mellitus were included. The patients were divided into groups with and without retinopathy. No subgroups were made according to the level of retinopathy. The aim was to compare the serum selenium level of patients between groups. Therefore, other variables that may contribute to the development of retinopathy were also recorded. The duration of diabetes, medications used, and glycosylated hemoglobin levels were recorded. The retinopathy group included 47 patients, and the non-retinopathy group included 68 patients. Selenium levels were measured in plasma samples. Results: The mean selenium level of the retinopathy group (70.11 [17.28] μg/l) was significantly lower than that of the non-retinopathy group (80.20 [19.10] μg/l) (P=0.005). The median duration of diabetes mellitus was significantly higher in the retinopathy group than in the non-retinopathy group (10 [1-25] and 6 [1-21], respectively; P=0.002). Logistic regression analyses showed that higher levels of blood selenium were independent preventive factors against the occurrence of retinopathy (OR [95% CI]: 0.965 [0.939-0. 991]). The duration of diabetes mellitus was an independent risk factor for retinopathy occurrence [OR (95% CI): 1.131 (1.050-1.219)]. One unit increase in selenium level was associated with a unit decrease in diabetic retinopathy of 0.965 (0.939-0.991). Conclusion: Our research revealed a correlation between the duration of diabetes and the incidence of diabetic retinopathy. Furthermore, a notable difference was observed in blood selenium levels between patients with diabetic retinopathy and those without it. Specifically, patients with diabetic retinopathy had lower plasma selenium levels compared to the control group. These findings have potential implications for the treatment or prevention of diabetic retinopathy, but more research is needed to determine the efficacy of selenium supplementation for diabetic patients with or without microvascular complications. Future studies should investigate the effect of selenium deficiency on different subtypes of diabetic retinopathy and the impact of selenium supplementation in this patient population.

Aim: Chronic kidney disease creates a tendency to infections, and infections are the second most common reason for mortality following cardiovascular events in chronic kidney disease. Health authorities recommend vaccination against hepatitis B, annual influenza, pneumonia, zoster, tetanus, and new coronavirus disease for people with end-stage kidney disease. Vaccine-preventable diseases cause mortality in the adult population with chronic diseases. The primary purpose of this study is to investigate vaccination rates and awareness about vaccination among end-stage renal disease patients who were on renal replacement therapies in a single tertiary center in Turkey. Material and Method: 86 hemodialysis patients were included in this cross-sectional study. A questionnaire was used to investigate whether the patients were aware of the immunization schedule or not and whether they were vaccinated against hepatitis B virus, seasonal influenza virus, pneumonia, herpes zoster, tetanus, and SARS-CoV-2 or not. Results: Fifty-eight (67.4%) patients were vaccinated against SARS CoV2. 48(55.8%) patients were vaccinated against the Hepatitis B virus. 31 (36%) patients were vaccinated against Pneumococcus pneumonia. 48 (55.8%) patients have been vaccinated against the influenza virus annually. Only 14 (16.3%) patients were vaccinated against tetanus during the previous 10 years, and only 1 (1.2%) patient was vaccinated against Herpes zoster. Influenza vaccination rates were found to be higher in patients with a longer duration of hemodialysis when compared to the other group(p=0.03). SARS-CoV 2 vaccination rates were higher in patients who were older than 59 years of age when compared to the younger patients(p=0.03). Conclusion: Vaccination rates are far from the targets in patients with end-stage kidney disease. The most common reason to be unvaccinated is a lack of enough knowledge about the subject.

This study was conducted to investigate the response of acute phase proteins, mainly Haptoglobin, C-reactive protein, Procalcitonin and the negative acute phase response, especially albumin in goats suffering from C. pseudotuberculosis. A total of 19 Turkish hair goats between the ages of 1.5 and 2 years in a special dairy farm was selected for the study, consisting of 9 healthy animals and 10 with C. pseudotuberculosis. There was a statistically significant difference in serum haptoglobin, C-reactive protein, procalcitonin and albumin levels in goats with C. pseudotuberculosis, compared to the control group (p less than 0.05). The results showed that Haptoglobin, C-reactive protein and Procalcitonin produce a higher, and Alb a lower, response in goats with C. pseudotuberculosis compared to the control. The presented study suggests that C. pseudotuberculosis can influence the level of acute phase proteins in goats. These results indicate that monitoring a number of acute phase proteins can increase the diagnostic information available for this disease.