Cytomegalovirus (CMV) colitis is a critical condition associated with severe complications in ulcerative colitis (UC). This study aimed to investigate the diagnostic value of the presence of CMV DNA in intestinal mucosa tissue and blood samples in patients with active UC. This study included 81 patients with exacerbated symptoms of UC. Patient data were obtained from the Hospital Information Management System. CMV DNA in colorectal tissue and plasma samples were analyzed using a real-time quantitative PCR assay. CMV markers were detected using immunohistochemistry and hematoxylin–eosin staining. Immunohistochemistry positivity was observed in tissue samples from eight (9.9%) patients. Only one (1.2%) patient showed CMV-specific intranuclear inclusion bodies. CMV DNA was detected in 63.0% of the tissues (median: 113 copies/mg) and in 58.5% of the plasma samples (median: 102 copies/mL). For tissues, sensitivity and the negative predictive value (NPV) for qPCR were excellent (100.0%), whereas specificity and the positive predictive value (PPV) were low (41.9% and 15.7%, respectively). For plasma, sensitivity and NPV were high (100.0%) for qPCR, whereas specificity and PPV were low (48.6% and 24.0%, respectively). CMV DNA ≥392 copies/mg in tissue samples (sensitivity 100.0% and specificity 83.6%) and ≥578 copies/mL (895 IU/mL) in plasma samples (sensitivity 66.7% and specificity 100.0%) provided an optimal diagnosis for this test. The qPCR method improved patient management through the early detection of CMV colitis in patients with UC. However, reliance on qPCR positivity alone can lead to overdiagnosis. Quantification of CMV DNA can improve diagnostic specificity, although standardization is warranted.

Aim: Brucellosis is the most common bacterial zoonosis in all around the world and still a public health threat with high rates of incidence in Turkey. In the present study, we evaluated the brucella infection cases, manifested in Sirnak, one of the regions that brucellosis is common in our country. Materials and Methods: We retrospectively collected data of 83 outpatients and inpatients who admitted infectious disease department of a second-line hospital between dates of October 2017 and December 2018. We have evaluated possible risk factors for brucellosis, complaints of the patients, the initiation time of the complaints, clinical signs, complications and treatment regimes. Results: 61.4% (51/83) of the patients included in the study were female. The mean age of the patients was 35.3 (15-84). Brucella infection was most common among housewives (39.7%) and the most common risk factor was fresh dairy cheese consumption (78.3%). The most common symptom was muscle and joint pain. We have applied 13 different treatment regimens in the form of double and triple drug combinations, and treatment of 13.2% of the patients was switched because of various reasons. 30.1% of the patients infected with brucella had hepatitis and 13.2% had osteoarticular involvement. Erythrocyte sedimentation rate (p = 0.009) and C reactive protein (p = 0.046) were statistically significant high in patients with osteoarticular involvement compared to without. The correlation between higher Erythrocyte sedimentation rate (p = 0.009), C reactive protein (p = 0.046) values and osteoarticular involvement was statistically significant. Epididymoorchitis was developed in three patients (3,6%). The rate of relapse was 26.5%. Conclusion: Brucella infection should be kept in mind in patients presenting with nonspecific symptoms, especially in areas where brucella infection is common like our region and patients should be examined for brucellosis.

Cisplatin (CIS) is a highly effective chemotherapeutic drug, but one of its most serious side effects is hepatonephrotoxicity, which varies based on its dosage and duration of use. Previous studies have reported that obtusifolin (OBS) exhibits several pharmacological effects, including antioxidant and antidiabetic activities. In this study, we investigated the protective effects of OBS against CIS-induced hepatonephrotoxicity. OBS (0.5 and 1 mg/kg, i.p.) was administered to male mice for 10 days, while CIS (20 mg/kg, i.p.) was administered on day 7 to induce hepatonephrotoxicity. The results showed that OBS reduced the CIS-induced elevations in AST, ALT, ALP, BUN, and creatinine levels by approximately 14%, 11%, 9%, 18%, and 14%, respectively. OBS also decreased liver and kidney MDA levels by approximately 31% and 25%, while enhancing liver and kidney GSH, SOD, and CAT levels by 50–36%, 80–70%, and 95–55%, respectively. In association with oxidative stress and the apoptotic process, OBS reduced liver and kidney mRNA expression levels of Nrf2 (by approximately 1.7- and 1.6-fold, respectively), HO-1 (by 1.6- and 1.4-fold, respectively), and Bcl-2 (by 1.6- and 1.4-fold, respectively). Additionally, OBS suppressed the mRNA expression levels of NF-κB (by 0.7- and 0.7-fold), TNF-α (by 0.6- and 0.6-fold), Bax (by 0.8- and 0.7-fold), and Cas-3 (by 0.7- and 0.7-fold). Protein expression analysis revealed that OBS increased Nrf2 (showing a 1.7- to 1.2-fold) and Bcl-2 levels (by 1.3- to 1.8-fold), and reduced Bax (by 0.7- to 0.8-fold) and caspase-3 (by 0.7- and 0.7-fold) levels altered by CIS treatment. Histopathological examinations confirmed that OBS reduced liver and kidney damage caused by CIS. In conclusion, OBS significantly improved CIS-induced hepatonephrotoxicity by reducing oxidative stress, inflammation, and apoptosis via modulation of the Nrf2/HO-1 pathway. These findings suggest that OBS could be a potential therapeutic agent for mitigating the side effects of chemotherapeutics.

Objectives: To assess the prognostic significance of Borrmann classification subtypes in patients with stage 2–3 gastric cancer who underwent surgical treatment. Methods: A retrospective review of 96 gastric cancer patients treated at Van Yüzüncü Yıl University Medical Faculty Hospital from 2008 to 2024 was conducted. Patients were included if they were aged >18 year (yr), had undergone surgery without neoadjuvant therapy, had no distant metastases, and had a postoperative pathological stage of 2-3. Demographic and clinicopathological data were documented, and median overall survival (OS) was analyzed according to the Borrmann classification. Results: The median age of the 96 patients was 66 yr, and 36.4% were female. Total gastrectomy was performed in 45.8% of cases. According to the Borrmann classification, type 2 tumors (49%) were the most common. The tumor was most frequently located in the antrum and pylorus (45.8%), and adenocarcinoma was the predominant histopathological type (77.1%). Recurrence was observed in 63.5% of cases. The median OS was 54.66 months, with survival rates of 74.8% at 2 yr and 48.7% at 5 yr. Among Borrmann subtypes, type 1 tumors had the highest median OS (110.1 months) (p=0.787). Conclusion: Although patients with Borrmann type 1 tumors had the highest OS rate, no significant prognostic differences were observed across the four Borrmann subtypes.

Background/Objectives: Spinosin, a flavone glycoside derived from medicinal plants, has been widely studied for its neuroactive properties; however, its effects on gastric injury remain unclear. Therefore, this study investigated the potential protective role of spinosin against HCl/ethanol-induced gastric lesions and its association with Nrf2/HO-1-related antioxidant responses. Methods: Gastric ulceration was experimentally induced in male Swiss albino mice by intragastric administration of 0.3 M HCl in 70% ethanol. Spinosin was administered orally at doses of 10 and 20 mg/kg, while omeprazole (20 mg/kg) was used as a reference treatment. Results: HCl/ethanol exposure led to pronounced oxidative stress and inflammatory responses, as reflected by increased levels of MDA, NFκB, IL-6, TNF-α, Cox-2, iNOS, IL-1β, Bax, and Cas-3, along with reduced antioxidant enzyme activities (GSH, SOD, CAT), decreased PGE2 and NO levels, and downregulation of Nrf2, HO-1, and Bcl-2 expression. Spinosin administration significantly attenuated gastric injury, suppressed pro-inflammatory mediators, reduced markers of lipid peroxidation and apoptosis, and enhanced antioxidant defenses. In parallel, spinosin treatment was associated with increased expression of Nrf2, HO-1, and Bcl-2. Conclusions: These findings suggest that spinosin mitigates gastric damage and is associated with attenuation of oxidative stress, inflammatory responses, and apoptosis, suggesting a possible contribution of Nrf2/HO-1-related antioxidant responses.

Pankreas fonksiyon testleri, kronik pankreatit veya pankreas kanseri gibi hastalıklara bağlı gelişen ekzokrin pankreas yetmezliğinin (EPY) teşhisinde kritik rol oynamaktadır. Bu testler, doğrudan (direkt) ve dolaylı (indirekt) olmak üzere iki ana kategoriye ayrılır. Altın standart olarak kabul edilen direkt testler, sekretin ve kolesistokinin gibi uyarıcılar eşliğinde duodenal sıvının toplanarak bikarbonat ve enzim düzeylerinin ölçülmesine dayanır; bu yöntemler özellikle hafif evre yetmezliği saptamada %90 duyarlılığa sahiptir. İndirekt testler ise daha basit ve ekonomik olup dışkıda yağ, fekal elastaz-1 veya kimotripsin ölçümü gibi yöntemleri kapsar. Fekal elastaz-1, stabil yapısı ve yüksek spesifitesi ile klinik uygulamada en sık tercih edilen indirekt yöntemdir. Steatore (yağlı dışkılama) ancak pankreasın fonksiyonel kapasitesinin %90’ı kaybolduğunda ortaya çıktığından, fekal yağ ölçümü gibi yöntemler erken teşhis için yetersiz kalabilmektedir. Teşhis sürecinde genellikle önce indirekt testlere başvurulur; klinik şüphe devam etmesine rağmen sonuç alınamazsa direkt testler veya sekretin destekli MR görüntüleme gibi ileri teknikler kullanılır. Fonksiyonel yetmezlik saptandıktan sonra altta yatan etiyolojinin, özellikle adenokarsinom riskine karşı detaylıca araştırılması gerekmektedir. Pancreatic function tests play a critical role in diagnosing exocrine pancreatic insufficiency (EPI) caused by conditions such as chronic pancreatitis or pancreatic cancer, and they are categorized into direct and indirect methods. Direct tests, considered the gold standard, involve collecting duodenal fluid to measure bicarbonate and enzyme levels following stimulation with secretagogues like secretin and cholecystokinin, providing up to 90% sensitivity in detecting mild insufficiency. Indirect tests are simpler and more cost-effective, encompassing methods such as fecal fat measurement, fecal elastase-1, or chymotrypsin assays, with fecal elastase-1 being the most preferred indirect method in clinical practice due to its stability and high specificity. Because steatorrhea only occurs when 90% of the pancreas's functional capacity is lost, methods like fecal fat measurement are insufficient for early diagnosis. The diagnostic process typically begins with indirect tests, followed by direct tests or advanced techniques like secretin-enhanced MRI if clinical suspicion persists. Once functional insufficiency is confirmed, the underlying etiology must be thoroughly investigated, particularly to rule out ductal adenocarcinoma in cases of new-onset steatorrhea and weight loss.