Biochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX survey

Summary Vitamin D intake over the recommended dose is usually associated with high serum 25(OH)D levels and gener ally not associated with symptoms of hypercalcemia. High doses of cholecalciferol need to be avoided to protect against vitamin D toxicity and related complications. Strict adherence to the clinical guidelines for treating vitamin D defciency can ensure safe and efective treatment. Purpose We observed a tendency to use high doses of cholecalciferol for vitamin D defciency treatment or vitamin D supplementation. We aimed to determine the biochemical characteristics of patients with high normal and elevated serum 25(OH)D levels. Methods An online invitation was sent to all tertiary endocrinology clinics in Turkey to complete an online retrospective survey (DeVIT-TOX Survey) for patients diagnosed with high serum 25(OH)D levels (>88 ng/mL) between January 2019 and December 2019. The patients were evaluated according to the presence of signs and symptoms of hypercalcemia and doses of vitamin D intake, evaluated into the following three groups according to their 25(OH)D levels: group 1,>150 ng/ mL; group 2, 149–100 ng/mL; and group 3, 99–88 ng/mL. Results A total of 253 patients were included in the fnal analysis (female/male: 215/38; mean age, 51.5±15.6 years). The average serum 25(OH)D level was 119.9±33 (range, 88–455) ng/mL, and the average serum calcium level was 9.8±0.7 (range, 8.1–13.1) mg/dL. Most (n=201; 75.4%) patients were asymptomatic despite having high serum 25(OH)D and cal cium levels. The serum 25(OH)D level was signifcantly higher in the symptomatic groups than in the asymptomatic groups (138.6±64 ng/mL vs. 117.7±31 ng/mL, p<0.05). The most common cause (73.5%) associated with high serum 25(OH) D levels was the inappropriate prescription of a high dose of oral vitamin D (600.000–1.500.000 IU) for treating vitamin D defciency/insufciency in a short time (1–3 months). The cut-of value of 25 (OH) D level in patients with hypercalcemia was found to be 89 ng/mL [median 116.5 (89–216)]. Conclusions High dose of vitamin D intake is associated with a high serum 25 OH D level, without symptoms of hypercal cemia. Inappropriate prescription of vitamin D is the primary cause for elevated 25(OH) D levels and related hypercalcemia. Hypercalcemia may not be observed in every patient at very high 25(OH) D levels. Adherence to the recommendation of guidelines is essential to ensure safe and efective treatment of vitamin D defciency

Identifying clinical characteristics of hypoparathyroidism in Turkey: HIPOPARATURK‑NET study

Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 ± 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 ± 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5–10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 ± 5.53 vs. 9.09 ± 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 ± 1214 vs. 1846 ± 1355 mg/day, p = 0.0193) and calcitriol (0.78 ± 0.39 vs. 0.69 ± 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients

Country-based analysis of COVID-19 publications in the first few months of the pandemic

Dear Editor, Assisted by the advanced technology and trade, the novel coronavirus has swiftly diffused around the globe. In a matter of few months, by March 2020, the world was faced with a pandemic1 . The fatality rates have varied within a wide band according to countries. Hospital capacities have been tested severely as SARS-CoV-2 spread at unprecedented rates, causing COVID-19 patients to need heavy hospitalization and intensive care. In almost all countries, lockdowns have led to economic and psychological problems. The urgency and global scope of the pandemic created a lacuna to be filled by national and international information sharing. Almost all scientific journals have prioritized COVID-19 and published additional issues to share the knowledge and experience on COVID-19. The need for inter-disciplinary and multidisciplinary collaboration required a prompt adaptation of academics to the crisis management

The Importance of Lower Gastrointestinal Tract Endoscopy Regarding the Preoperative Evaluation of Malignant Adnexal Masses

AbstractObjective: Our aim in this study was to investigate the value of lower gastrointestinal system (GIS) endoscopy regarding the detection of colon invasion and its importance in recognizing primary and secondary ovarian cancers in cases clinically prediagnosed as advanced stage ovarian cancers.Materials and Methods: Records of patients, who were operated due to adnexal mass suspicious for malignancy at our clinic between September 2012 and May 2017, were examined. One hundred thirteen cases of advanced stage (Stage III – IV) malignant adnexal masses were detected.Results: Cases that underwent laparotomy because of a prediagnosis of malignant adnexal mass (mostly ovarian), and had stage III and IV disease, were compared regarding clinical characteristics and foreseeing bowel resection (51 patients had undergone lower GIS endoscopy, 62 had not). Six of the 51 patients, who underwent endoscopy, were diagnosed with colon involvement during endoscopy while 4 other patients were diagnosed intraoperatively. Among the 62 patients, without preoperative endoscopy, 10 patients underwent intraoperative bowel resection. The mean age of the patients with bowel resection was 57.35±13.53y; the mean age of the remaining patients was 55.8±12.54y. Rectosigmoid region was the most common area of resection (17/20). The positive predictive value of colonoscopy for predicting bowel resection was 100%, while the negative predictive value was 91%.Conclusion: Bowel resection is a pivotal component of the surgical approach to advanced stage malignant adnexal masses. The detection of tumor spread in lower GIS endoscopy is very important while planning the surgery, dealing with postoperative stoma problems and emotional issues and during the differential diagnosis of metastatic tumors.</div

Consumer Sentiment in Turkey, from Closure to the New Normal

The main aim of the study was to analyze consumer sentiment in the COVID-19 pandemic period in the context of Turkey. In this context, “expectations of consumers regarding the changes in their current income and general expenditures in the economic conditions brought along with normalization process” and “in what direction consumer sentiment would change in the 6-month period following the normalization process in Turkey” were investigated. Based on these research questions, a descriptive study was conducted by adopting a quantitative research method. The questionnaire method was employed in the collection of the study data. As the COVID-19 pandemic was still ongoing when the study was conducted, the data were collected through an online questionnaire by using the convenience sampling method. The data that were obtained from 1147 participants were analyzed by using descriptive statistics through SPSS 24 software. The results that were obtained demonstrated that almost half of the consumers anticipated a decrease in their income in the 6-month period following the normalization process, and that they expected their expenditures would be reduced. In addition, it was determined that consumers were pessimistic in terms of the potential changes that would occur in their personal savings and family living conditions. Hence, it was found that consumers did not expect a considerable improvement in their economic and living conditions in the 6-month period following the normalization process. As the results that were obtained from consumers’ expectations were conscious estimations, as discussed in the assumption of rational expectations theory, they support the estimations of this economic theory

F1 Melez Armut Populasyonunun Ateş Yanıklığı Hastalığı Etmeni Erwinia amylovora Karşı Reaksiyonunun Belirlenmesi

In this study, susceptibility levels of different hybrid pear individuals were determined against fire blight disease agent Erwinia amylovora by artificial inoculations. According to the pathogenity tests of 75 different E. amylovora strains, made on apple and pear shoots, highly virulent 7 strains were used in the testing of the hybrids. E. amylovora suspension was prepared with equal mixes of these 7 selected strains. This suspension was inoculated to hybrid plants by shoot injections that carried out twice, in August 2010 and May 2011. According to the evaluations made through necrotic shoot rate, totaly 7495 hybrid seedlings inoculated, and 11,91% of them were “the least susceptible” 3,99% were “less susceptible”, 6,62% were “moderately susceptible”, 18,07% were “highly susceptible”, 59,41% were “the most susceptible”. More “the least susceptible” pear hybrids were obtained from the combinations of resistant Magness cultivar than the other combinations.Ateş Yanıklığı hastalığına dayanıklı armut tiplerinin belirlenmesini amaçlayan bu çalışmada, melez armut bireylerin Ateş Yanıklığı hastalığı etmeni Erwinia amylovora’ya karşı duyarlılık durumu suni inokulasyonla ortaya konmuştur. Bireylerin testlemesinde, 75 farklı E. amylovora izolatı içinden, elma ve armut sürgünlerinde yapılan patojenite testlerine göre virulensi yüksek olan 7 izolat seçilerek kullanılmıştır. Melez bireyler bu izolatların eşit oranda karışımlarından oluşan E. amylovora süspansiyonu ile Ağustos 2010 ve Mayıs 2011 tarihlerinde sürgün injeksiyonuyla iki kez inokule edilmiştir. Sürgün yanıklığı oranına göre yapılan değerlendirmede, testlenen 7495 melez bitkiden, %11,91’u “çok az duyarlı”, %3,99’u “az duyarlı”, %6,62’si “orta derecede duyarlı”, %18,07’si “duyarlı” ve %59,41’i “çok duyarlı” grupta yer almıştır. Dayanıklı Magness çeşidinin ana ebeveyn olarak kullanıldığı kombinasyonlarda “çok az duyarlı” grupta yer alan birey sayısının yüksek olduğu görülmüştür

Consumer Sentiment in Turkey, from Closure to the New Normal

The main aim of the study was to analyze consumer sentiment in the COVID-19 pandemic period in the context of Turkey. In this context, &ldquo;expectations of consumers regarding the changes in their current income and general expenditures in the economic conditions brought along with normalization process&rdquo; and &ldquo;in what direction consumer sentiment would change in the 6-month period following the normalization process in Turkey&rdquo; were investigated. Based on these research questions, a descriptive study was conducted by adopting a quantitative research method. The questionnaire method was employed in the collection of the study data. As the COVID-19 pandemic was still ongoing when the study was conducted, the data were collected through an online questionnaire by using the convenience sampling method. The data that were obtained from 1147 participants were analyzed by using descriptive statistics through SPSS 24 software. The results that were obtained demonstrated that almost half of the consumers anticipated a decrease in their income in the 6-month period following the normalization process, and that they expected their expenditures would be reduced. In addition, it was determined that consumers were pessimistic in terms of the potential changes that would occur in their personal savings and family living conditions. Hence, it was found that consumers did not expect a considerable improvement in their economic and living conditions in the 6-month period following the normalization process. As the results that were obtained from consumers&rsquo; expectations were conscious estimations, as discussed in the assumption of rational expectations theory, they support the estimations of this economic theory