Abstract Objectives: In the past decade, advances in immunological therapy have increased the survival of kidney recipients and their grafts. However, it has not achieved the desired level of improvement. This study aims to reveal the mortality among kidney recipients. Methods: Medical data of the patients, who had undergone kidney transplantation (KT) between November 2010 and December 2020, were retrospectively reviewed. Inclusion criteria were adult kidney recipients, who had died. Exclusion criteria were pediatric recipients, recipients of en bloc and dual KT, recipients with missing data, and recipients with a primary non-functioning graft. The recipients were grouped according to their donor type; Group 1 (from a living donor) and Group 2 (from a deceased donor). Subgroup analyses were done for mortality by time-period post-transplant and for infectious causes of mortality. Results: Of 314 recipients, 35 (11.14%) died. Twenty-nine recipients were included in the study (Group 1: 17 and Group 2: 12). The most common cause of mortality was infection (58.6%), and the second was cardiovascular disease (CVD) (24.1%). Sepsis developed in 29.4% of infection-related deaths, while COVID-19 constituted 23.5% of infection-related deaths. Conclusion: Early diagnosis and treatment of infectious and CVD are important to improve survival in kidney recipients.

Resumen Objetivos: En la última década, los avances en la terapia inmunológica han aumentado la supervivencia de los receptores de riñón y sus injertos. Sin embargo, no se pudo lograr el nivel de mejora deseado. Este estudio tiene como objetivo revelar la mortalidad entre los receptores de riñón. Materiales y métodos: Se revisaron retrospectivamente los datos médicos de los pacientes, que se habían sometido a un trasplante de riñón entre Noviembre de 2010 y Diciembre de 2020. Los criterios de inclusión fueron los receptores de riñón adultos, que habían fallecido. Los criterios de exclusión fueron los receptores pediátricos, los receptores de trasplantes de riñón dual y en bloque, los receptores con datos faltantes y los receptores con un injerto primario no funcionante. Los receptores se agruparon según su tipo de donante; Grupo 1 (de un donante vivo) y Grupo 2 (de un donante fallecido). Se realizaron análisis de subgrupos para la mortalidad por período de tiempo posterior al trasplante y para las causas infecciosas de mortalidad. Resultados: De 314 beneficiarios, 35 (11,14%) fallecieron. Se incluyeron 29 receptores en el estudio (Grupo 1:17; Grupo 2:12). La causa más común de mortalidad fue la infección (58,6%) y la segunda fue la enfermedad cardiovascular (24,1%). La sepsis se desarrolló en el 29,4% de las muertes relacionadas con la infección, mientras que el COVID-19 constituyó el 23,5% de las muertes relacionadas con la infección. Conclusión: El diagnóstico y tratamiento tempranos de enfermedades infecciosas y cardiovasculares es importante para mejorar la supervivencia de los receptores de riñón.

Scorpion stings are common in Turkey due to its geographical location, climate and socioeconomic structure. Scorpion envenomation cases are a considerable public health problem in all regions of the country. Important health-threatening scorpions in Turkey are Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus and M. eupeus, all of which belong to the Buthidae family. They are described to be potentially dangerous to humans. So far, there is no study about scorpion sting incidence covering all geographical regions of Turkey; therefore, in this study, we analyzed the frequency of scorpion sting cases in the country. A total of 24,261 scorpion sting cases were reported during 2005. Most of which (about 80%) occurred in the Southeastern Anatolia (30.4%), Mediterranean Sea (24.9%) and Aegean regions (23.5%), where medically important scorpion species are found. The sting cases mostly occurred during the summer period. Our results suggest that scorpion stings are an important problem in Turkey. This simple descriptive study will help develop interventions to prevent scorpion stings, which should take local sting cases into consideration.

Scorpions are venomous arthropods of the Arachnida class and are considered relatives of spiders, ticks and mites. There is not any study about the biochemical effects of Androctonus crassicauda (Olivier, 1807) venom. Therefore, in the present study, we aimed at evaluating the toxicity of the venom from A. crassicauda, which is responsible for a number of deaths of infants, children and adults in tropical and subtropical countries. For this purpose, rats (n=35) were divided into seven groups of five animals each; venom solutions (250µg/kg) were subcutaneously injected into rats; blood samples were taken from each animal at various times; and serum biochemical parameters were measured (levels of total proteins, total bilirubin, albumin, globulin, urea, creatinine, uric acid, glucose, cholesterol, triglycerides, sodium, chlorine, potassium and calcium, and the activity of the enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, lactate dehydrogenase). Serum levels of glucose, cholesterol, aspartate aminotransferase, alanine aminotransferase and uric acid increased in envenomed animals, compared to controls. There was a statistically positive correlation between Na+ and Cl- ions.

Scorpions can be considered living fossils because they have changed so little during the last 400 million years. They are venomous arthropods of the Arachnida class and regarded as relatives of spiders, ticks and mites. The aim of the present study was to evaluate the toxicity of Androctonus crassicauda (Olivier, 1807) venom and its effects on the acetylcholinesterase (AchE) activity and on electrolytes levels in rats. Animals were divided into seven groups of five rats each. Test groups received 250µg/kg of venom solution while control group was treated with 200µl of physiological saline solution (PSS). Blood samples were collected from the animals on the 1st, 2nd 4th, 8th, 12th, and 24th hours after subcutaneous injection of venom. Animals were monitored for 24 hours. Androctonus crassicauda venom significantly reduced AchE activity on the 12th hour when compared with control group. A statistically negative correlation between Na+ and K+ (p<0.05) and a positive correlation between Na+ and CL- (p<0.001) ions levels were observed after the administration of A. crassiccauda venom to rats. We can conclude that the differences in the electrolytes levels are due to acute renal failure, since elimination of toxin occurs primarily via the kidney.

Scorpion envenomation remains a real health problem in many countries. In scorpionism cases, it is often recommended that patients be treated with species-specific antivenom. Androctonus crassicauda venom has been used as antigen for antivenom production in Turkey, where this antivenom, called Turkish antivenom, has also been effective in the treatment of envenomation caused by species other than A. crassicauda. The present study aimed at determining the paraspecific effects and potency of the Turkish antivenom against Mesobuthus gibbosus (Brullé, 1832) venom. To assess the venom toxicity and the antivenom efficacy, we determined the Minimum Lethal Dose (MLD) and the Minimum Effective Dose (MED) instead of LD50 and ED50, respectively. Androctonus crassicauda antivenom was capable of neutralizing M. gibbosus venom (20 MLD). This was the first study indicating that A. crassicauda antivenom can be used for the treatment of Mesobuthus gibbosus stings, especially in Aegean Region, Turkey.

Scorpions are venomous arthropods of the class Arachnida and are considered relatives of spiders, ticks and mites. There are approximately 1,500 species of scorpions worldwide, which are characterized by an elongated body and a segmented tail that ends in a venomous stinger. No specific treatment is available for scorpion envenomation, except for the use of antivenom. The current study aimed at comparing protein content and lethality of Androctonus crassicauda venom extracted by two different methods (electric stimulation and maceration of telsons). The LD50 calculated by probit analysis was 1.1mg/kg for venom obtained by electric stimulation and 39.19mg/kg for venom obtained by maceration of telsons. In the electrophoretic analysis, protein bands of the venom sample obtained by electric stimulation were between 12 and 53kDa (total: five bands), and those of venom extracted by maceration appeared as multiple protein bands, relative to the other venom sample. Low-molecular-weight proteins, revealed by western blotting, played an important immunogenic role in the production of antivenom. Lethality and protein levels varied according to the extraction method; venom obtained by the maceration technique showed lower toxicity than that obtained by electric stimulation.

Scorpions are included in the order Scorpiones; class Arachnida. Lethal scorpions are mostly of the Buthidae family. Among these, species belonging to Androctonus, Leiurus and Mesobuthus genera cause most scorpion envenomations in Turkey. This study was performed aiming the production of antivenom by using Androctonus crassicauda telsons. Venom toxicity is related to telson weight, size, and storing condition (open or closed). Telsons of A. crassicauda were collected in Southeastern Anatolia (especially in Harran town, Sanliurfa), Turkey. They were separated according to weight, size, and storing condition - open (a) and closed (b). Venom solution was prepared by maceration of telsons. Swiss albino mice were used to determine the lethal dose 50% (LD50), which was as follows: Group 1a - 2.31mg; Group 1b - 2.66mg; Group 2a - 2.32mg; Group 2b - 2.66mg; Group 3a - 6.66mg; Group 3b - 6.88mg. Among the groups of telsons, the first and the second groups showed different characteristics. However, there were no differences between their toxicity. In the third group, a fourfold amount of telsons was used for toxicity. In other words, telsons weighting from 19.99 to 20mg (first group) and from 29.99 to 30mg (second group) presented similar LD50 values, and telsons weighting from 10 to 19.99mg (third group) showed a fourfold higher LD50 value. This difference was caused by the maturity of scorpions and venom toxicity was related to their size. The first and second groups were considered to be mature and the third group, not adult. Therefore, we can conclude that obtaining open telsons due to environmental factors was not effective for venom toxicity.

The present study was carried out to produce highly efficient antivenom from a small number of telsons in a short time. Venom solution was prepared through maceration of telsons from Androctonus crassicauda (Olivier, 1807) collected in the Southeastern Anatolia Region, Turkey. Lethal dose 50% (LD50) of the venom solution injected into mice was 1 ml/kg (95% confidence interval; 0.8-1.3), according to probit analysis. Different adjuvants (Freund's Complete Adjuvant, Freund's Incomplete Adjuvant, and 0.4% aluminium phosphate), at increasing doses and combined with venom, were subcutaneously injected into horses on days 0, 14, 21, 28, 35, and 42 of the experiment. Antivenom was collected from the immunized horses on days 45, 48, and 51 using the pepsin digestive method. The antivenom effective dose 50% (ED50) in mice was 0.5 ml (95% confidence interval; 0.40-0.58), according to probit analysis. It was concluded that 0.5 ml antivenom neutralized a venom dose 35-fold higher than the venom LD50. Thus, highly potent antivenom could be produced from about 238 telsons in 51 days.

The aim of the present study was to analyze the parametric values of Androctonus crassicauda (Oliver, 1807), the most significant scorpion species in Turkey. For this purpose, 11 male and 11 female A. crassicauda specimens were collected from Sanliurfa region. The body parts most important for species identification were measured by using sensitive calipers. Differences between sexes were statistically significant for pectinal organ length (female: 7.50±1.26mm;male: 8.63±1.05mm; p=0.033), pectinal tooth count (female: 25.36±0.86;male: 33.36±0.80; p=0.000), and carapace width (female: 10.27±1.19mm;male: 9.09±0.73mm; p=0.000). However, body length (female: 90.09±14.74mm;male: 82.95±5.40mm), abdomen width (female: 12.09±1.90mm;male: 11.09±0.88mm), and metasoma length (female: 43.09±3.08mm;male: 44.63±6.50mm) were not significantly different between sexes.

The epidemiology and clinical findings of scorpion stings in Sanliurfa region of Turkey, from May to September 2003, were evaluated in this study. Mesobuthus eupeus (M. eupeus) plays a role on 25.8% of the scorpionism cases. This study also showed that intoxications caused by M. eupeus in the southeast of Anatolia region were seen in hot months of the summer, especially on July. Females and people above 15 years old were mostly affected and stung on extremities. Intense pain in the affected area was observed in 98.7% cases, hyperemia in 88.8%, swelling in 54.6%, burning in 19.7%, while numbness and itching were seen less frequently. In our study, the six most frequently observed symptoms were local pain, hyperemia, swelling, burning, dry mouth, thirst, sweating, and hypotension. In this study involving 152 M. eupeus toxicity cases, patients showed local and systemic clinical effects but no death was seen. Autonomic system and local effects characterized by severe pain, hyperemia and edema were dominantly seen in toxicity cases.

The objective of this study was to determine the effect of the heat treatment of full-fat soyabean (FFSB) and solvent extracted soyabean meal (SBM) on the in situ dry matter (DM) and protein degradability, and in vitro gas production kinetics of the protein sources. Ruminal disappearance of DM and crude protein (CP), and in vitro gas production were determined after 0, 4, 8, 16, 24, 48 and 72 h incubation using the in situ ruminal degradation and in vitro gas production techniques, respectively. In situ DM and CP disappearances were fitted to the exponential equation p = a + b (1-e-ct), where a is the rapid degradable fraction and b is the slow degradable fraction. In vitro gas production data were fitted to the equation, y = A {1 - exp [- b (t-T) - c (√t - √T)]}. Where b and c are the initial gas production rate constant (h-1) and later gas production rate constant (h-12), respectively. The two protein sources were heat treated both with steam pressure in an autoclave at 120 °C and in an oven at 150 °C for 20 min. Heat treatment had a significant effect on effective DM degradability (EDMD), effective CP degradability (ECPD) and in vitro gas production. Although the heat treatments reduced the EDMD, ECPD and the amount of gas produced, the results were inconsistent between protein sources. The heat treatments applied in the autoclave and the oven reduced the ECPD0.02 of FFSB by 12.5% and 10.9%, respectively. On the other hand, heat treatment applied through the autoclave decreased the ECPD0.02 of SBM by 13.9%, but by 18.7% when heat was applied through the oven. Heat treatment of SBM using the oven seemed to be more effective than using autoclaving. Heat treatments in the autoclave and oven reduced the total gas production from FFSB by 7.25 and 7.32%, respectively, and from SBM by 12.69 and 7.91%, respectively. It was concluded that heat treatment is an effective method of altering the rumen degradation characteristics of DM and CP in SBM and FFSB. Both methods could be used to increase the proportion of the rumen non-degradable protein fraction in protein sources which would then reach the small intestines unaffected by ruminal fermentation.

The objective of this study was to determine the effect of inclusion of polyethylene glycol (PEG 8000) during in vitro incubation on gas production kinetics, organic matter digestibility (OMD) and the metabolisable energy (ME) content of foliage from the tannin containing tree species, Pistica lentiscus, Arbutus andrachne and Juniperus communis. The amount of gas produced when the foliage was incubated with buffered rumen fluid, was determined after 0, 3, 6, 12, 24, 48, 72 and 96 h of incubation in the presence of PEG at inclusions rates of 15, 30, 60 and 90 mg and in the absence of PEG. Their kinetics were described using the equation p = a + b (1-e-ct). Addition of PEG resulted in an increased gas production at almost all incubation times in all tree species. However species showed variable responses. After 3 h of incubation the PEG addition showed no significant effect on gas production when the foliage from A. andrachne was incubated, but had a significant effect on gas production as duration of incubation extended. The increase in gas production in response to increased levels of PEG inclusion was linear for P. lentiscus and J. communis. However, when the PEG inclusion rates exceeded 60 mg there was no significant increase in gas production when A. andrachne was incubated. The estimated parameters such as gas production rate(c) and gas production (a) from the immediately soluble fraction were not affected by the level PEG treatment, except that PEG addition at 90 mg had a significant effect on the gas production (a) from immediately soluble fraction of leaves of J. communis. Gas production (b) from the insoluble fraction (mL) and potential gas production (a+b), OMD and ME of tree leaves increased significantly with increasing levels of PEG addition. However, when PEG inclusion exceeded 60 mg these parameters showed no significant increase when leaves from A. andrachne were incubated. Although the mean increase in OMD per mg PEG supplementation was 0.131 digestibility units, the increase in ME per mg PEG supplementation was 0.0201 ME units. The elevated levels of gas produced, and increased OMD and ME estimates with the inclusion of PEG demonstrated the negative effect of tannins in foliage on digestibility.

The aim of this study was to determine the effects of cultivar and formaldehyde treatment of barley grains on rumen fermentation characteristics using the in vitro gas production technique. Amount of gas produced (mL/g organic matter (OM)) during fermentation was determined after 0, 3, 6, 12, 24, 48, 72 and 96 h of incubation in buffered rumen fluid. The gas production kinetics were described using the equation: y = A {1 - exp [- b (t-T) - c (√t - √T)]} where b and c are the initial gas production rate constant (h-1) and later gas production rate constant (h-1/2), respectively. Cultivar and formaldehyde treatment had significant effects on gas production kinetics. Total gas production (A) ranged from 389.9 to 410.8 (mL/g OM) with the cultivar, Esterel, producing the largest volume of gas of the cultivars. Due to low gas production rates at 3, 6 and 12 h of incubation the cultivars, Viva and Cecilla, took the longest to produce 50% of their total volume of gas. Formaldehyde treatment reduced the rate (μ) of gas production at 3, 6 and 12 h of incubation, and the total volume of gas (A), but increased the time (h) to produce 50% of A and reduced the time (h) to produce 95% of A. The reduction in gas production ranged from 33.3 to 51 mL/g OM with 6 h incubation showing the highest decrease in gas production. It is concluded that formaldehyde treatment may provide an opportunity to manipulate the site of digestion of barley grain in the digestive tract of ruminants. Through the selection of suitable cultivars and through formaldehyde treatment the nutritional and health problems associated with the fermentation of barley grain in the rumen could be reduced.