Introduction: Meteorin-like (Metrnl), also known as subfatin, is a recently discovered adipokine with a favourable effect on insulin sensitivity. Studies have shown lower Metrnl levels in obese patients. However, data on its circulating levels in type 2 diabetes mellitus (T2DM) patients are contradictory. This study aims to evaluate serum Metrnl levels in T2DM patients and determine the relationship between serum Metrnl levels and insulin resistance in these patients. Material and methods: This cross-sectional study was conducted among 150 participants. The study was carried out between June 2019 and December 2019 at the internal medicine outpatient clinic of a tertiary university hospital. The participants were divided into three groups: group 1 (control group, n = 50), group 2 (newly diagnosed T2DM, n = 50), and group 3 (long-standing diagnosed T2DM, n = 50). An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of Subfatin (Metrnl), and the correlations of Metrnl level with anthropometric parameters, HOMA index, and biochemical measurements were assessed. Results: There was no statistically significant difference between the gender (p = 0.468) and age (p = 0.067) characteristics of the three groups. The Metrnl (subfatin) levels of the participants were as follows: control group-20.05 (1.56-103.78); newly diagnosed T2DM group-2.62 (1.25-103.78); and long-standing diagnosed T2DM group-2.01 (0.80-19.84) pg/mL. The Metrnl (subfatin) levels of the participants in the control group were higher than in the participants in the newly diagnosed T2DM and long-standing diagnosed T2DM groups (p < 0.001). Subfatin demonstrated a negative correlation with insulin and HOMA-IR in the control group and long-standing diagnosed T2DM group. Conclusions: The subfatin level was found to be higher in the healthy control group than in both diabetic patient groups. Subfatin level showed negative correlation with both insulin level and HOMA index. There was a relationship between subfatin and insulin resistance. Low levels of subfatin in the diabetic patient groups may play a role in the pathogenesis of T2DM by increasing insulin resistance.

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.

Chronic obstructive pulmonary disease (COPD) is an important public health problem and it is associated with systemic inflammation. Mean platelet volume (MPV) is one of the markers indicating platelet activation, and there are different results in different diseases related to inflammation. As for COPD some studies found it to be high whereas others found low results. In this study, we aimed to study parameters like MPV, platelet distribution volume (PDW), red blood cell (RBC), which are studied in the complete blood count testing routinely of patients with COPD, smoking and nonsmoking subjects without chronic diseases. Data of 121 patients with COPD, 101 nonsmoking subjects and 102 smoking subjects were retrospectively enrolled. Results were statistically analyzed. MPV levels were lower in patients with COPD compared with smokers (P<0.001) and nonsmoking subjects (P<0.001) but platelet levels were not significantly different. PDW levels found to be lower in COPD group compared with smokers (P<0.013) and nonsmokers (P<0.001). White blood cells were higher in patients with COPD as were expected (P<0.001). Neutrophil levels also were higher in patients with COPD compared with smokers (P<0.003) and nonsmokers (P<0.0001). RBC levels were lower in patients with COPD when compared with nonsmokers (P<0.001). The results of this study suggest that the decreased MPV and PDW may be used as negative reactants for evaluation of COPD.

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Annular pancreas is a rare congenital anomaly that consists of a ring of pancreatic tissue partially or completely encircling the second part of the duodenum. It can affect anyone from neonates to adults, and is difficult to diagnose because it can present in a wide range of clinical conditions. Although cases have also been reported in adults, symptomatic cases are often referred in infancy or early childhood.A 17-year-old female patient who was diagnosed as having annular pancreas is reported. The patient had had non-bilious vomiting accompanied by abdominal pain, especially 5-10 minutes after meals, for seven years. Annular pancreas, which may be seen at any age, should be considered in the differential diagnosis of patients with non-bilious vomiting, particularly after meals, over a long period.

Introduction Critical illness polyneuropathy (CIP) is a clinical condition frequently seen in patients being treated in critical care units in the final stage of sepsis. The etiopathology of CIP is still unclear, and the onset time of appearance of the electrophysiological findings has not been elucidated. The very little research that has been carried out on this topic is limited to clinical electrophysiological and histopathological studies. In this study, electrophysiological alterations in the early stage of experimentally induced sepsis were investigated in septic rats.

Perforan dermatozlar, kollajen, elastin, fibrin gibi dermal bileşenlerin transepidermal eliminasyonu ile karakterize bir grup hastalıktır. Perforan dermatozlar, temelde transepidermal eliminasyon ile karakterize olan (primer perforan dermatoz) veya klinik seyirleri sırasında transepidermal eliminasyonun sekonder olarak geliştiği deri hastalıkları olarak ortaya çıkabilirler (sekonder perforan dermatoz). Perforan dermatozlar primer olarak reaktif perforan kollajenoz (RPK), elastozis perforans serpiginoza (EPS), perforan folikülit (PF) ve edinsel perforan dermatoz (EPD) olmak üzere dört ana hastalık formunu kapsar. Bunlardan genellikle diabetes mellitus (DM) ve kronik böbrek yetmezliğiyle (KBY) ilişkilendirilen Perforating dermatoses are a group of diseases characterized by transepidermal elimination of dermal components such as collagen, elastin and fibrin. Perforating dermatoses primarily include four main forms: Reactive perforating collagenosis, elastosis perforans serpiginosa, perforating folliculitis and acquired perforating dermatosis. There is limited data about perforating dermatoses in the literature. Because of their rare appearance, they can be easily misdiagnosed. Acquired perforating dermatosis is a systemic disease such as diabetes and chronic renal failure; and it should be considered in case of pruritic papulonodules and giant plaques with central crater in a patient. In addition to the treatment of underlying disease in the first stage; narrow band ultraviolet B (nbUVB) is evaluated to be effective in these cases. Based on its rare occasions, we submit a giant variant of acquired perforating dermatosis with a collagen fiber predominant elimination pattern, which is treated with nbUVB.

Araştırmanın amacı, Türkçe öğretmenlerinin yazma eğitimiyle ilgili karşılaştıkları sorunları ve bu sorunlara yönelik çözüm önerilerinin neler olduğunu tespit etmektir. Bu amaç doğrultusunda araştırma, nitel araştırma yöntemlerinden olgubilim (fenomenoloji) deseni çerçevesinde yapılandırılmıştır. Araştırmanın katılımcılarını Millî Eğitim Bakanlığı bünyesinde görev yapan 25 Türkçe öğretmeni oluşturmaktadır. Katılımcıların görüşlerini tespit etmek için yarı yapılandırılmış görüşme formu kullanılmıştır. Elde edilen bulgular içerik analizine tabi tutularak irdelenmiş ve kategoriler hâlinde sunulmuştur. Araştırma sonucunda elde edilen bulgulara göre yazma eğitimi sürecini olumsuz etkileyen unsurların “öğrenci; aile, okul ve çevre; ders kitabı; ders saati ve müfredat; MEB ve eğitim sistemi; öğretmen; öğrencilerin ilkokul eğitimi; öğretmenlerin lisans eğitimi” olmak üzere sekiz farklı nedene dayandığı tespit edilmiştir. Öğretmenlerin yazma becerisini geliştirmek için sundukları önerilerin ise “öğrenci; uygulama, etkinlik; aile, okul ve çevre; ders kitabı; ders saati ve müfredat; MEB ve eğitim sistemi; öğretmen; öğrencilerin ilkokul eğitimi; öğretmenlerin lisans eğitimi” olmak üzere dokuz farklı kategoride toplandığı görülmüştür. Görüşme yapılan öğretmenler, yazma eğitimini olumsuz etkileyen unsurlar konusunda farklı görüşler ortaya koymuşlar, söz konusu sorunları çözmeye yönelik ise daha dar kapsamlı öneriler geliştirmişlerdir.