Background: Atopic dermatitis (AD) and food allergy (FA) are common allergic diseases in early childhood. AD may be concomitant with FA, particularly in young children. Although studies report the prevalence of FA in children with AD, there is insufficient data regarding different phenotypes of FA. Objective: The aim of our research was to determine the prevalence and clinical predictors of different phenotypes of concomitant FA in children with AD. Methods: This cross-sectional multicenter study included patients younger than 24 months old diagnosed with AD, recruited from 14 pediatric allergy centers. Patients were categorized into two groups using skin testing, allergen-specific IgE, and ultimately food challenge testing (FCT): those with FA and those without. Individuals with FA were classified into three distinct phenotypes: IgE-mediated, non-IgE-mediated, and concurrent IgE- and non-IgE-mediated. Results: The data of 530 children [59% male, median-age 7 months (IQR: 5–11)] were analyzed. IgE-mediated FA was found in 28.1% of participants, whereas 22.4% (n = 119/530) exhibited non-IgE-mediated FA. Concurrent IgE- and non-IgE-mediated FA was reported in 12.1% (n = 64/530) of patients. Cow’s milk (69.6%) and egg-white (68.9%) were identified as the most prevalent allergens. Cow’s milk was primarily responsible for non-IgE-mediated and egg-white for IgE-mediated FA. The most significant predictors of FA were severe AD and the presence of blood in stool with odds ratios of 8.25 (95% Cl: 3.04–22.39) and 10.04 (95% CI: 2.03–49.59), respectively (p < 0.01) (p < 0.005). Conclusions: The study’s findings indicate that children with early-onset and mild-to-moderate AD deserve to be comprehensively assessed for FA symptoms. The most significant indicators of concomitant FA in AD patients were the presence of blood in stool and severe AD. It is important to consider that those who exhibit IgE-mediated FA may also have concurrent non-IgE-mediated FA. We underline that it is important to consider that children with AD who exhibit IgE-mediated FA may also have concurrent non-IgE-mediated FA. Addressing these symptoms may assist healthcare practitioners in clinical practice to improve the quality of care for AD patients having FA.

INTRODUCTION:Tobacco companies use social media to bypass marketing restrictions. Studies show that exposure to tobacco promotion on social media influences subsequent smoking behavior, yet it is challenging to monitor such content. We developed an artificial intelligence that can automatically identify tobacco-promoting content on social media. AIMS AND METHODS:In this mixed methods study, 177,684 tobacco-related tweets published on Twitter in Turkish were collected. Through inductive content analysis of a sample of 200 tweets, the main mechanisms by which tobacco is promoted on social media were identified. Then, a sample of 5000 tweets was deductively analyzed and labeled based on those mechanisms. A pre-trained transformer-based Large Language Model was fine-tuned using the labeled dataset. Then, tobacco promotion in all tweets was predicted using this model. RESULTS:The main mechanisms of tobacco promotion on social media included modeling the behavior, expressing positive attitudes, recommending use, and marketing brands or vendors. The developed model identified tobacco-promoting social media content with 87.8% recall and 81.1% precision. The utility of the model was demonstrated in the analysis of tobacco promotion in tweets for a period of a month. CONCLUSIONS:This tool makes it possible to monitor tobacco promotion in social media and creates new opportunities for tobacco control policy and practice, not only in surveillance and enforcement but also in health promotion. IMPLICATIONS:Tobacco promotion in social media is a well-known yet hard-to-addressed problem due to the nature of social media. This study leverages a cutting-edge AI approach, Large Language Models, to identify tobacco promotion in social media content automatically and precisely. The developed model offers better prediction performance than previously proposed techniques. The study enables surveillance of tobacco-promoting content both for research purposes and enforcement of tobacco control measures. Furthermore, we suggest a range of health promotion opportunities this tool can help with from developing personal skills to creating supportive environments and strengthening community actions.

Objective: Anesthesia healthcare workers work under more intense hazard, risk and excessive workload specific to their field, in addition to the problems of other healthcare workers. This study aims to identify perception of occupational risks in the working environment, knowledge about occupational health and safety (OHS), and the use of personal protective equipment in the working environment among the anesthesia healthcare workers. Methods: This descriptive study was conducted with 153 anesthesia healthcare workers. The healthcare workers participating in the study were divided into 2 groups according to their work: physicians and non-physician healthcare workers. The questionnaire included sociodemographic, knowledge about occupational risks and Occupational Health and Safety Law (OHSL), use of personal protective equipment and knowledge of OHS in the institution questions. Results: The frequencies of the working conditions and professional practice areas of the group of doctors being not ergonomically appropriate (p=0.005), insufficient lighting (p=0.001), insufficient heat (p<0.015), chemical agent exposure (p=0.024), ionizing radiation exposure (p=0.003), exposure to biological agents (p=0.022), exposure to psychological risk factors (p=0.017) were found to be statistically significantly higher. In this study, it was found that the perception of working environment conditions and occupational risk factors was higher in doctors, and their knowledge of OHSL and OHS practices in the institution was higher in the non-physician group. Conclusion: The OHS trainings received by the health care workers were effective for the results. Increasing knowledge about occupational risks and preventive measures against them can reduce the incidence and consequences of possible occupational diseases. Keywords: Anesthesia, occupational health, occupational safety

Blood cells are used as the most sensitive marker to determine the effects and intensity of ionizing radiation. This descriptive study aimed to evaluate the effect of radiation exposure on hematological parameters in healthcare workers who were exposed to radiation in a university hospital between May and June 2021. A total of 339 participants were included, of which 169 (49.9%) were radiation workers and 170 (50.1%) were in the control group. A decrease was observed in white blood cell and neutrophil counts in those exposed to ionizing radiation for less than 10 years; however, white blood cell, neutrophil, hemoglobin levels decreased, and red cell distribution width (RDW) levels increased in those exposed to ionizing radiation for 10 years or more (p < 0.005). A statistically significant increase was observed in the RDW and lymphocyte levels as the years of work experience in the profession increase in the group exposed to IR. The findings indicate that the effect of low-dose ionizing radiation on the hematopoietic system is related to the frequency and duration of the dose. Hematological parameters can be sensitive biomarkers of low-dose ionizing radiation; possible disturbances in the hematopoietic system can be recognized before the onset of symptoms, and necessary precautions can be taken promptly.

Objective: The aim of this study is to evaluate the knowledge, attitude, and anxiety levels of healthcare workers in Turkey and South Africa and to determine the possible factors associated with anxiety. Methods: A cross-sectional study with 864 healthcare workers in Turkey and South Africa was conducted during May 1-October 30, 2020. The questionnaire included sociodemographic, individual, work-related, and about coronavirus disease 2019 questions. Anxiety was measured with the Beck Anxiety Inventory. Results: A total of 864 people answered the questionnaire, 527 from South Africa and 337 from Turkey. Healthcare workers in both countries have mild anxiety levels, and the median value of the Beck Anxiety Scale score was significantly higher in the participants from South Africa (10) than the participants in Turkey (8) (P = .004). Compared to Turkey, the risk of moderate/severe anxiety was 1.56 times higher in South Africa. Female gender, duties out of work definition, difficulties of chronic illness management, difficulties in accessing the treatment of mental health problem, living with a person who is older than 65 or has a comorbidity, and personal protective equipment support were found to be associated with moderate/severe anxiety (P < .05). Conclusion: In order to reduce the mental health impact on healthcare workers, pandemic readiness plans must take into account working hours and workload, adequate personal protective equipment supply, and measures to provide psychological support to healthcare workers, especially those with pre-existing mental health illnesses. Cite this article as: Güngördü N, Kara B, Mosam A, et al. The relationship between sociodemographic differences and knowledge, attitude and anxiety levels during the coronavirus disease 2019 pandemic: A cross-sectional study on healthcare workers in Turkey and South Africa. Cerrahpasa Med J. 2023;47(2):215-221.

Background: Occupational factors, working conditions, age, gender, exercise, acquired habits, and stress affect a person’s sleep quality. The aim of this study was to investigate sleep quality, work stress, and related factors among office workers in a hospital. Methods: This cross-sectional study was conducted with office workers actively working in a hospital. A questionnaire consisting of a sociodemographic data form, the Pittsburgh Sleep Quality Index (PSQI), and Swedish Demand-Control-Support Scale were used to assess the participants. Results: The mean of PSQI score was 4.32±2.40 and 27.2% of the participants had poor sleep quality. In the multivariate backward stepwise logistic regression analysis, it was found that shift workers were 1.73 times (95% CI: 1.02-2.91) more likely to have poor sleep quality, and a one-unit increase in work stress score increased the risk of having poor sleep quality by 2.59 times (95% CI: 1.37-4.87). An increase in age was found to decrease the risk of poor sleep quality in workers (OR=0.95; 95% CI: 0.93-0.98). Conclusion: This study suggests that reducing workload and increasing work control as well as enhancing social support will be effective in preventing sleep disturbances. It is important, however, in terms of providing guidance for hospital employees in planning future measures to improve working conditions.

Objective: This study aimed to evaluate the exposure status of the healthcare workers in our hospital and to evaluate the factors affecting the exposure levels. In this direction, it is aimed to contribute to the planning of measures that can be taken to reduce the risk exposure rate of healthcare workers. In our hospital, the “Outpatient Clinic for Healthcare Personnel with COVID-19 Exposure” was established in order to monitor the coronavirus disease 2019 exposure risks of healthcare workers. Methods: The data of our study, designed as a retrospective cohort study, were obtained from the follow-up records of 1646 healthcare workers presenting with risk exposure for COVID-19 between March 24, 2020, and January 15, 2021. Risk assessment in healthcare workers according to the “Algorithm for Evaluation of Healthcare Professionals with COVID-19 Exposure” of the Ministry of Health was classified as no risk and low-, medium-, and high-risk exposure. The relationship between the risk levels of the participants, demographic, workplace characteristics, and personal protective equipment use was evaluated. Results: A total of 1646 personnel were applied to our coronavirus disease 2019 exposure personnel outpatient clinic. The majority (90%) of the applicants were not employed in a coronavirus disease 2019-related unit. While 43 (2.6%) personnel were evaluated as risk free, 233 (14.2%) personnel were classified as high-risk exposures, 1012 (61.8%) as medium-risk exposures, and 349 (21.3%) as low-risk exposures. During the follow-up period, 201 (12.2%) of the applicants were found to be coronavirus disease 2019 positive. More coronavirus disease 2019 positivity was seen in personnel with high-risk exposures (P = .003). Conclusion: In our study, hospital-based exposure constitutes the most important source of exposure for healthcare workers. It has been observed that the number of coronavirus disease 2019 exposures and disease development in healthcare workers who do not work in coronavirus disease 2019 units is high. High-risk exposure increases the likelihood of developing coronavirus disease 2019 in healthcare workers. Cite this article as: Aydın SN, Can G, Esen BK, et al. Evaluation of healthcare workers presenting to the outpatient clinic for COVID-19 exposure at a university hospital during pandemic in Turkey. Cerrahpaşa Med J. 2023;47(2):222-228.

Quality of life is at the forefront of the goals that all societies aim to achieve today. This is the main reason why measuring quality of life is a routine procedure in many studies. This study was carried out by undergraduate and associate degree students of health sciences; the aim of this study was to evaluate and compare the quality of life. The research was carried out on a total of 200 undergraduate and associate degree students studying in the health sciences departments of the same university in a one-year period. In order to obtain the demographic information of the students; the personal data collection form created by the researchers and the World Health Organization Quality of Life Scale-Short Form (WHOQOL-Bref) were applied by one to one interview technique. The voluntariness of the participants was taken as a basis in filling out the questionnaires. SPSS-22 program was used to evaluate the data in our study. By making descriptive statistics, two independent groups were compared between the groups. The mean age of the associate degree students participating in our study was 20.6 +/- 1.26, and the undergraduate students were 20.8 +/- 3.07. When the last question, the 27th environmental question, is included in the WHOQOL-Bref scale, which consists of four sub-parameters, the name of the scale is named WHOQOL-Bref-TR. In our study, which we evaluated with WHOQOL-Bref-TR, the scores of undergraduate students in the "psychological field" sub-category were found to be significantly higher (p<0.05) than associate degree students in comparisons made based on education level. In the comparison made according to genders, the difference in general health, psychological, and environmental dimensions was not significant (p>0.05). In conclusion; in all comparisons, the level of quality of life and problem solving abilities do not differ depending on gender. As the education level increases; the psychological state, which has an effect on the quality of life, increases positively. With the data obtained, suggestions were made to curriculum arrangements and university administrations in order to increase the quality of life of young adults.

Objective: The aim of this study was to determine the physical, biological, chemical, ergonomic, and psychological occupational exposures experienced by anesthesiologists working at such an intense tempo and effects of these exposures on employees1 health. Methods: A total of 160 anesthesia staff among the 225 (71%) individuals participated in the study. Participants were given a three-part questionnaire, consisting of 42 questions examining sociodemographic characteristics, chronic diseases, and physical, chemical, biological, ergonomic, and psychological exposures in the working environment. The anesthesiologists participating in the study were divided into 2 groups according to their working environment in the hospital: those who work in the operating room (OR) and those who perform anesthesia outside the operating room (NOR). Results: While 55% and 27% of the OR group suffered from fatigue frequently and sometimes, respectively, 33% and 34% of the NOR group experienced fatigue frequently and sometimes (P = .017). In addition, varicose veins (P = .035) and vertigo (P = .02) complaints were significantly higher in the OR group compared to the NOR group. While the number of people in the OR group who stated that their mental energy was exhausted was significantly higher than the NOR group (P = .013), no significant difference was observed between the groups with regards to their physical energy (P = .15). Conclusion: The workload and working conditions of anesthesiologists as a whole are quite harsh. Detailed studies regarding workplace environment exposures and prevention from those exposures have great importance on both employee and patient safety. Cite this article as: Yılmaz AK H, Mazıcan N, Özşahin Y, et al. The effects of the operating room environment on the health of anesthesiologists in a university hospital. Cerrahpaşa Med J. 2021;45(3):185-191.

Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow’s milk, hen’s eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow’s milk-induced acute urticaria was 92% (95% CI: 81–96%). A history of cow’s milk-induced and/or hen’s egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen’s kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). Conclusion: Cow’s milk, hen’s eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.

Pharmaceutical Track and Trace System (PTTS) is a successful implementation of Track and Trace approach which has been applied since 2010 in Turkey. Briefly, it defines the infrastructure framework for all units belonging to each product and works by using the Datamatrix code, which provides the sureness of the uniqueness. The aim of this study was to evaluate the community pharmacy personnel's attitudes and knowledge about the PTTS, in order to reveal their expectations and identify problems thereof. 56 community pharmacies located in Beyoglu district of Istanbul, Turkey (n = 120) were included. The data were collected from 15th - 30th of April 2017 by a structured questionnaire. Besides evaluating descriptive statistics, chi(2) test was conducted to analyse relationship between demographics and knowledge, attitudes, and practices of the pharmacy personnel, respectively. This study shows that PTTS is found useful especially for providing drug safety and facilitating and accelerating the recall of the drugs.

Background One-fifth of COVID-19 patients are seriously and critically ill cases and have a worse prognosis than non-severe cases. Although there is no specific treatment available for COVID-19, early recognition and supportive treatment may reduce the mortality. The aim of this study is to develop a functional nomogram that can be used by clinicians to estimate the risk of in-hospital mortality in patients hospitalized and treated for COVID-19 disease, and to compare the accuracy of model predictions with previous nomograms. Methods This retrospective study enrolled 709 patients who were over 18 years old and received inpatient treatment for COVID-19 disease. Multivariable Logistic Regression analysis was performed to assess the possible predictors of a fatal outcome. A nomogram was developed with the possible predictors and total point were calculated. Results Of the 709 patients treated for COVID-19, 75 (11%) died and 634 survived. The elder age, certain comorbidities (cancer, heart failure, chronic renal failure), dyspnea, lower levels of oxygen saturation and hematocrit, higher levels of C-reactive protein, aspartate aminotransferase and ferritin were independent risk factors for mortality. The prediction ability of total points was excellent (Area Under Curve = 0.922). Conclusions The nomogram developed in this study can be used by clinicians as a practical and effective tool in mortality risk estimation. So that with early diagnosis and intervention mortality in COVID-19 patients may be reduced.

Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods: We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6-18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.

Objectives:Proposals for scientific studies must have an original hypothesis and the appropriate design and methodology to test the premise.Methods:This study is an evaluation of the suitability of applications submitted to a local ethics committee (EC) and the rate of publication of that research.Results:A total of 899 files submitted for EC approval were retrospectively assessed. The EC found that the description of the methods in 44% of the applications was inaccurate, and that this type of error was most often seen in submissions from the surgical branch. In all, 52% of the applications for which we were informed about their final status were not published.Conclusion:The results suggest that improved training in epidemiology is required to reduce the number of application errors and that new regulations could help to motivate healthcare personnel to conduct scientific research and publish their findings.

Introduction Turkish Continence Society aimed to analyze how overactive bladder (OAB) is being managed in routine practice by the urologists in Turkey. Material and methods Fourteen urology departments were randomly selected to represent the whole population in this multicenter study. An online data entry and storage software was created for patient recruitment and data assessment. A survey including demographic data, daily habits, lower urinary tract symptoms, and Turkish-validated OAB-V8 and ICIQ-SF questionnaires were completed by all patients. Second part of the survey, including the questions about clinical evaluation and management of the patient, was completed by the treating physician. Results A total of 507 patients (394 female and 113 male) were included. Behavioral therapy was recommended to 73.2% of female and 81.4% of male patients although bladder diary was requested for 59.5% and 52.7% of the female and male patients, respectively. In the first visit, 86.1% of the female and 89.3% of the male patients were given antimuscarinics (P = .431). Antimuscarinic-related side effects occurred in 94.9% and 88.9% of the female and male patients, respectively (P = .937). However, the rate of medical treatment change due to antimuscarinic-related side effects was only 1.7% in female and 4.8% in male patients at the end of 4 months. Conclusions Behavioral therapy and antimuscarinics were the preferred initial treatment modalities of OAB in concordance with the guidelines. Despite guideline recommendations, bladder diaries were not utilized in half of the patients. Insufficient efficacy appeared to be the main reason for treatment modification.

In the Ereğli‐Ulukıșla Basin, southern Turkey, crude oil shows have been observed in the subsurface in the shale‐dominated non‐marine Upper Miocene – Pliocene succession. Based on analyses of samples from four boreholes, the shales’ organic matter content, thermal maturity and depositional characteristics are discussed in this study. Geochemical correlations are established between shale extracts and a crude oil sampled from the shale succession. The shales have moderate to high hydrogen index (HI) and very low oxygen index (OI) values. Pyrolysis data show that the shales contain both Types I and II kerogen, and n‐alkane and biomarker distributions indicate that organic matter is dominated by algal material. Very high C26/C25 and C24/C23, and low C22/C21 tricyclic terpane ratios and C31 R/C30 hopane, C29/(C28+C29) MA and DBT/P ratios in shale extracts indicate that deposition occurred in a lacustrine setting. High gammacerane and C35 homohopane concentrations and low diasterane/sterane ratios with a very low Pr/Ph ratio suggest that both the shales and the source rocks for the oil were deposited in a highly anoxic environment in which the water column may have been thermally stratified.Although the shales analysed have very low Tmax values, the production index is quite high which suggests that the shales are early‐mature to mature. Biomarker ratios including C32 22S/(22R+22S) homohopanes, C29 20S/(20R+20S) and ββ(ββ+αα) steranes, moretane/hopane, TA(I)/TA(I+II) and MPI‐3 all suggest that the shales are within the oil window. Heavy components of free hydrocarbons (S1) within the shales may have been recorded as part of the Rock‐Eval S2 peak resulting in the low Tmax values.The oil and shale extracts analysed are similar according to their sterane and triterpane distributions, suggesting that the oil was generated by the shales. However burial depths of the Upper Miocene – Pliocene shale succession are not sufficient for thermal maturation to have occurred. It is inferred that intense volcanism during the Pliocene – Pleistocene may have played an important role in local maturation of the shale succession.

Background and Design.- Malnutrition and inadequate dialysis are associated with increased morbidity and mortality in hemodialysis (HD) patients. In this study our aim was to assess nutritional status and adequacy of dialysis in HD patients. Thirty four HD patients (17 male, 17 female) and 41 healthy (21 male, 20 female) controls were enrolled. Twenty two patients were followed at our Dialysis Unit, Department of Nephrology, Medical Faculty, Kocaeli University, twelve patients were followed at the Dialysis Unit, Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University. In HD patients mean age was 51±18 (range 16-76) years and median time on dialysis was 10 (minumum 6-maximum 264) months. In healthy volunteers mean age was 44±12 years. Anthropometrics measurements such as body mass index (BMI), triceps skinfold thickness (TST), mid-arm circumference (MAC) was done in HD patients and controls. Dietary protein and calorie intake were calculated by means of a food reports to be recorded by the patients. Duration of food report was 3 days. Hemoglobin, hematocrit, serum urea, creatinine, albumin, total cholesterol, potassium, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone, immunoglobulins, complement, iron, total iron-binding capacity, ferritin concentrations, blood pH and bicarbonate were measured and transferrin, normalized protein catabolic rate (nPCR), urea reduction ratio (URR), Kt/V were calculated in the patients. Statistical analysis was performed with the SSPS (Statistical Package for Social Science) for Windows Version 10.0 system using Student.s t test, Pearson correlations and Mann-Whitney U test. Results.- The mean BMI, TST and MAC values were lower in the HD patients compared to the control group (p 0.05). There was significant correlation between nPCR as a nutritional marker and URR, Kt/V (Jindal) and Kt/V (Daurgidas) as adequacy of dialysis markers (p<0.05). There was significant correlation between albumin and creatinine, nPCR and urea, phosphorus and urea, phosphorus and creatinine, phosphorus and potassium (p<0.05). Conclusion.- In conclusion mild protein malnutrition was present in our patients with inadequate protein intake. In addition targeted adequacy of dialysis was not achieved. For these reasons, in HD patients should be monitored nutritional status and adequacy of dialysis and measures should be taken as necessary. * Anahtar Kelimeler: Hemodiyaliz, beslenme durumu, diyaliz yeterliligi * Key words: Hemodialysis, nutritional status, adequacy of dialysis

Mediastinal fat has been suggested to be associated with cardiovascular diseases such as carotid stiffness, atherosclerosis and coronary artery calcification. We investigated the possible role of Ad-36-induced obesity in the pathogenesis of the coronary artery disease (CAD). Ad-36 DNA was investigated in the anterior mediastinal fat tissue samples of obese adults with CAD. Seventy-five obese adults with left main coronary artery (LMCA) disease, 28 non-obese adults with valvular heart diseases, and 48 healthy individuals without cardiovascular problems were included as the obese patient group (OPG), non-obese patient group (NOG) and healthy control group (HCG), respectively. We also simultaneously investigated Ad-36 antibodies by serum neutralization test (SNA), and measured leptin and adinopectin levels. Ad-36 antibodies were detected only in 10 patients (13.3%) within the 75 OPG. A statistically significant difference was detected between OPG, NOG and HCG in terms of Ad-36 antibody positivity (p>0.05). Ad-36 DNA was not detected in mediastinal tissue samples of OPG and NOP without PCR inhibitors. We suggest that Ad-36 may not have an affinity for mediastinal adipose tissue in obese patients with left main CAD and valvular heart diseases. Ad-36 antibody positivity results are not sufficient to reach a causal relationship.