Purpose: To investigate the quality of life (QoL) in patients with end-stage renal disease who underwent open or robot-assisted renal transplantation (ORT and RART). Materials and Methods: Patients who underwent ORT and RART at Bakirkoy Sadi Konuk Training and Research Hospital between June 2016 and December 2018 constituted the target population of this study. The patient group was divided into two groups as per the surgical technique (i.e., open vs. robot-assisted). Demographic data, preoperative and postoperative data of all patients were collected prospectively. The QoL of the patients was assessed preoperatively and on the postoperative 30th day. Results: 67 patients who underwent ORT and 60 patients who underwent RART were included. The mean patient age and BMI were calculated as 40,9 ± 11,6 years and 24,4 ± 2,9 kg/m2, respectively. While mean total ischemia time was shorter in the ‘open’ group, incision length, duration of surgical drainage and hospital stay were shorter in the ‘robot-assisted’ group. The physical component scores of the QoL questionnaire revealed that postoperative impairment of quality of life was more significant in the ORT than the RART. Conclusion: Patients who underwent RART have a higher QoL than the patients who were treated with ORT as per their self-reported QoL scores in the early postoperative period. Keywords: End-stage renal disease; Open renal transplantation; Robot-assisted renal transplantation; Quality of life

Objectives: In this study, we aimed to compare the outcomes and complication rates of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in geriatric patients according to Charlson comorbidity index (CCI). Materials and Methods: Between April 2011 and January 2020, patients who underwent PCNL and RIRS for renal stone between 10 and 30 mm in geriatric patients were retrospectively evaluated. All patients’ Pre-surgery comorbidities were recorded and the CCI was calculated. The two groups’ perioperative values, stone free rates and complication rates were compared. Postoperative complications were noted according to the Clavien scoring system. Results: There were 89 and 72 patients in the PCNL and RIRS group, respectively. The median age was 67 years in both of groups (p=0.192). The stone size were 22.2 ± 3.5 and 19.9 ± 7.1 in the PCNL and RIRS group, respec¬tively ( p = 0.082). CCI scores were similar in both groups (p=0.098). Stone free and complication rates were significantly higher in PCNL group (p = 0.021, p = 0.034). Also we found that overall complication and major complication rates were statistically significant difference with especially Charlson comorbidity index score ≥2 in PCNL group (p = 0,016, p = 0,029). According to correlation analysis of intraoperative and postoperative results with Charlson comorbidity index, there was positive correlation between total complication with PCNL and RIRS group, respectively (p < 0,001, p = 0.024). In addition, there was positive correlation between lenght of hospital stay with PCNL and RIRS group, respectively (p = 0,007, p < 0,001). Also there was positive correlation between blood transfusion requirement with PCNL group (p=0,009). Conclusion: Despite there was higher stone clearence in PCNL, the complication rates were higher compared to RIRS. So RIRS might be a safe alternative treatment method to PCNL in older patients with a high CCI score.

Objectives: During the pandemic, anxiety, stress, and depression may occur increasingly in the whole society. To evaluate the possible cause, incidence and levels of anxiety and depression in the relatives of the patients in the ICU in accordance with the patients’ SARS-CoV-2 PCR result. Materials and Method: The study was prospectively conducted on relatives of patients admitted to tertiary ICU during COVID-19 pandemic. Sociodemographic characteristics of the patients and their relatives were recorded. “The Turkish version of the Hospital Anxiety and Depression Scale” questionnaire was applied twice to the relatives of 120 patients to determine the symptoms of anxiety and depression in accordance with the PCR results of the patients (PCR positive n=60, PCR negative n=60). Results: The ratios above cut-off values for anxiety and depression among relatives of the patients were 45,8% and 67,5% for the first test and 46,7% and 62,5% for the second test respectively. The anxiety and depression in the relatives of PCR positive patients was more frequent than the PCR negative (p< 0,001 for HADS-A and p=0,034 for HADS-D). The prevalence of anxiety and depression was significantly higher in female participants (p=0,046 for HADS-A and p=0,009 for HADS-A). There was no significant correlation between HADS and age of the patient or education of the participants. The fact that the patients were hospitalized in the ICU during the pandemic was an independent risk factor for anxiety (AUC = 0.746) while restriction of patient visiting in the ICU was found to be an independent risk factor for depression (AUC= 0.703). Conclusion: While patient with positive PCR and participant with female gender is responsible for both anxiety and depression, hospitalization in the ICU due to COVID-19 is an independent risk factor for anxiety and restriction of patient visiting in the ICU is an independent risk factor for depression.

Objective: During the COVID-19 pandemic, quarantine and staying at home is advised. The social relationship between people has become deficient, and human social isolation (SI) has become the consequence of this situation. It was shown that SI has made changes in hippocampal neuroplasticity, which will lead to poor cognitive function and behavioral abnormalities. There is a connection between SI, learning, and memory impairments. In addition, anxiety-like behavior and increased aggressive mood in long-term isolation have been revealed during the COVID-19 outbreak. Methods: Term searches was done in Google Scholar, Scopus, ScienceDirect, Web of Science and PubMed databases as well as hand searching in key resource journals from 1979–2020. Results: Studies have shown that some drug administrations may positively affect or even prevent social isolation consequences in animal models. These drug treatments have included opioid drugs, anti-depressants, Antioxidants, and herbal medications. In addition to drug interventions, there are non-drug treatments that include an enriched environment, regular exercise, and music. Conclusion: This manuscript aims to review improved cognitive impairments induced by SI during COVID-19.

Objectives: Transcutaneous Tibial Nerve Stimulation (TTNS) is a non-invasive method used in OAB treatment. We aimed to compare the effectiveness of the once a week and three times a week TTNS procedure in women diagnosed with wet type refractory OAB. Methods: A total of 60 patients diagnosed with wet type OAB was refractory to medical treatment included in the study. Participants were equally and randomly divided into two groups: TTNS treatment was performed with a time duration of 30 minutes for 12 weeks, once a week to Groıp-I and three times a week to Group-II. Pre and post-treatment OAB-V8/ICIQ-SF scores and voiding frequencies recorded in the bladder diary were compared between groups. Results: Four patients in Group-1 and eight in Group-2 left the study without completing the treatment. TTNS was performed in both groups for 12 weeks. There was a significant decrease in the voiding frequency, OAB-V8, ICIQ-SF scores in both group-1 and group-2 (p<0.001). A significant decrease in the OAB-V8 score was observed in the 5th week in Group-1, and on the 3rd week in group-2. Complete response was observed in 6 patients (23.1%) in Group-1 after 12 weeks of TTNS procedure. In group-2, 10 patients (45.5%) had a complete response. After the 12-week TTNS procedure, no significant difference was observed between the groups in terms of treatment response. Conclusion: TTNS can be safely used before invasive treatments in resistant OAB. TTNS procedure three times a week seems more effective than performing it once a week.

Background: The current emergency medicine literature on cardioversion for atrial fibrillation (AF), describes its performance on those who are hemodynamically unstable, present within 48 hours of the onset of the arrhythmia, or are on long term anticoagulants. This article describes a clinical pathway comparing patients presenting to the emergency department (ED) with atrial fibrillation (AF) of more than 48 hours who underwent a transesophageal echocardiogram (TEE) and subsequent cardioversion in the ED. The objective of this study is to evaluate such a pathway looking at the time to cardioversion, length of hospital stay, rate of successful cardioversion, and the rate of complications compared to the traditional pathway of admitting patients directly to the cardiology department for evaluation and treatment. Methods: This was a retrospective observational study of patients who presented to the ED with AF for more than 48 hours, underwent a transesophageal echocardiogram, and then were electrically cardioverted either in the emergency department versus the cardiology ward. Results: Electrical cardioversion was performed in the ED on 92 patients (61%) and the cardiology department on 59 (39%). Over 90% of cardioversions were successful in both groups. Time to cardioversion was significantly less in the ED group versus the cardiology group (1.03 ± 0.8 days versus 4.17 ± 1.9; p<0.001). Similarly, the mean length of hospital stay was less for the ED group (1.5± 1.5 days versus 7.2 ± 3.5; p<0.001). Conclusion: Patients who present in atrial fibrillation for more than 48 hours and then have a TEE, undergo electrical cardioversion faster in the ED compared to the cardiology ward. This clinical pathway also results in a shorter length of hospital stay without having more side effects.

Purpose: Successful resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. This study aimed to determine the knowledge, skills, and attitudes of the pediatric healthcare professionals about the defibrillator use and to offer solutions if there was room for improvement. Procedures: This was a multicenter survey study. Findings: The study included 716 healthcare professionals with an average age of 30.1 ± 5.8 years; 50% (n=358) were pediatric residents and 41.3% (n=296) had less than three years of professional experience. Self-declared level of knowledge about defibrillation/cardioversion was low-to-medium for 66.5% (n=476); 60.8% (n=435) had never practiced these procedures and 22.2% (n=159) had never received any training about defibrillator use. There was a significant relationship between professional experience and the proportion of participants who correctly responded to the first-shock dose for defibrillation but not for cardioversion. Conclusion: Professional experience is crucial in the correct defibrillator use. However, the defibrillation/cardioversion procedures are prone to errors since they are not commonly applied in day to day practice. An ideal approach to improve the experience of personnel could be to use practical training with case-based simulations and to educate the personnel about the features of the defibrillators available in their clinics.

ABSTRACT Objective To evaluate the diagnostic accuracy of the 68Gallium (68Ga) - prostate specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) and multiparametric MRI (mpMRI) by region-based comparison of index tumour localisations using histopathological tumour maps of patients who underwent radical prostatectomy due to clinically significant prostate cancer. Patients and Methods The study included 64 patients who underwent radical prostatectomy after primary staging with mpMRI and 68Ga-PSMA PET/MRI. Diagnostic analysis was performed by dividing the prostate into four anatomic regions as left/right anterior and left/right posterior. The extension of the lesions in mpMRI and the pathological uptake in 68Ga-PSMA PET/MRI were matched separately for each region with the extension of the index tumour into each region. Results The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and the accuracy of mpMRI and 68Ga-PSMA PET/MRI are shown as 55.7%, 91.8%, 80.6%, 77.2%, 78.1% and 60.8%, 94.3%, 86.8% 79.8%, 83.5%, respectively. 68Ga-PSMA PET/MRI has higher sensitivity and specificity compared with mpMRI. However, no statistically significant difference was found (p = 0.464). Combined imaging had significantly higher diagnostic accuracy compared with mpMRI and 68Ga-PSMA PET/MRI (change in AUC: 0.084 and 0.046, p < 0.001 and p = 0.028, respectively), while no statistically significant difference was found between mpMRI and 68Ga-PSMA PET/MRI (change in AUC: 0.038, p = 0.246). Conclusion 68Ga-PSMA PET/MRI had higher clinical diagnostic accuracy in prostate cancer compared with mpMRI. Diagnostic accuracy was significantly increased in the combined use of both imaging modalities.

Objective: The aim of this study is establish the optimal non- invaszive urine sample collection method for the microbiota studies. Methodology: 12 men with bladder carcinoma underwent first voided and midstream urine collection. Urine samples were analyzed by using V3-V4 regions of bacterial 16s ribosomal RNAs. Bacterial groups with relative abundance above 1% were analyzed in first voided urine and midstream urine samples at phylum, class, order, and family level. At the genus level, all of the identified bacterial groups’ relative abundances were analyzed. The statistical significance (p<0.05) of differences between first voided and midstream urine sample microbiota were evaluated using the Wilcoxon test. Results: According to analysis, 8 phyla, 14 class, 23 orders, 39 families, and 29 different genera were identified in the first voided and the midstream urine samples. Statistical differences were not identified between first voided and mid-stream urine samples of all bacteria groups except the Clostridiales at order level (p:0.04) and Clostridia at class level (p:0.04). Conclusions: Either first voided or midstream urine samples can be used in urinary microbiota studies as we determined that there is no statistically significant difference between them regarding the results of 16s ribosomal RNA analysis. What’s known? According to widespread acceptance, first voided urine and midstream urine should be collected separately for standard microbiologic evaluation. What’s new? We found that there is no exact statistically significant difference between two collection methods even on microbiota analysis. We believe that either first voided or midstream uyrine samples can be used in urinary microbiota studies.

Introduction: In this study, it is planned to compare the RT-PCR test, which is the gold standard in the diagnosis of COVID-19, with Thorax computed tomography (CT) and rapid antibody test results. Methods: Patients who were admitted to the emergency service of İzmir Çiğli Training and Research Hospital between 01.04.2020 and 31.05.2020 and who were suspected of having COVID-19 infection were included in the study. The medical records of the patients were retrospectively analyzed through the hospital data processing database. Age, gender, hospitalization, status of home quarantine, real-time reverse transcription-polymerase chain reaction (RT-PCR), thorax CT and rapid antibody test results of the patients were examined. The relationship between RT-PCR, thorax CT and rapid antibody test results were compared statistically. Results: A total of 181 patients, 115 (63.5%) male and 66 (36.5%) female, with an average age of 56.4 ± 18.06 years were included in the study. The nasopharyngeal swab PCR result obtained at the first admission of the patients to the emergency department was positive in 71 (39.2%) patients. Thorax CT was performed in 173 (95.6%) patients who applied to the emergency department, and 112 (64.7%) of them had findings that could be compatible with COVID-19. According to the thorax CT findings in patients, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting COVID-19 infection were respectively; 76.1%, 43.1%, 48.2% and 72.1% (ĸ: 0.176, p <0.001). In our study, the mortality rate for COVID-19 was found to be 2.8%. Conclusion: Rapid antibody test and thorax CT examinations were found to have low diagnostic value in patients who admitted to the emergency department of our hospital and whose first RT-PCR SARS-CoV-2 test was positive. Studies involving larger patient groups are needed for their use alone in diagnosis and screening.

Purpose Many studies revealed that stress, anxiety and depressive symptoms are increased during the pandemic in both healthcare workers and the general public. In our study, we aimed to evaluate anxiety levels in patients who applied to an Ophthalmology outpatient clinic during the COVID-19) pandemic. We thought that close contact requirement in eye examination might lead to the anxiety of COVID-19. Methods This is a cross-sectional descriptive study conducted in Dicle University Ophthalmology department outpatient clinic. Data were collected for COVID-19 fear and safety measurements and all the patients were applied Hamilton Anxiety Scale (HAM-A). Results A total of 223 voluntary participants were recruited. Of the participants, 101 were female and 122 were male. HAM-A total score mean was found 9.28 ± 8.717 and approximately half of the patients (51.6%) had a score of higher than 6 which means clinical significance. Women and single participants had higher anxiety levels compared with men and married/partnership respectively. Age, educational level and fear of COVID-19 when visiting the hospital were found to be related to HAM-A levels. 41.7% of the patients had postponed the hospital admission because of the pandemic and this was also significantly associated with the anxiety levels. Conclusions This is the first study that investigates anxiety specifically in an eye clinic specifically during the COVID-19 outbreak. This study, apart from supporting the increased anxiety levels in the pandemic, highlights that anxiety must have caused a problem of proper access to health services. Key words: COVID-19, anxiety, pandemic, ophthalmology

Introduction: The opinion that latent T. gondii infection is having a broadly asymptomatic projection has now been interrogated, in specific due to the echoed association between the latent infection and an elevated incidence of schizophrenia or even suicide attempts. Notwithstanding conducted studies aimed to understand this feasible link are restricted. Methods: In the present case-control study, we focused to illuminate the relationship between the serological and molecular presence of T. gondii and schizophrenia with or without the suicide attempts by comparing it with healthy individuals. A total of 237 participants (117 in schizophrenia; 120 in healthy control) were included in this study. Results: Overall, latent T. gondii infections were found statistically higher in 63 (53.8%) of the 117 patients with schizophrenia and in 33 (27.5%) of the 120 controls (p < 0.001). In schizophrenia patients, seroprevalence T. gondii was again found to be statistically higher in suicide attempters (59.6%), compared to no history of suicide attempts (48.3%) (p < 0.05). The molecular positivity rate of T. gondii DNA was higher in the schizophrenia group, compared to the healthy control group (p < 0.05), whereas the history of suicide attempts was not statistically associated (p = 0.831) with T. gondii DNA positivity by PCR. Conclusion: This case-control study enlightens additional demonstration to the belief that T. gondii infection would be an underlying component for the pathophysiology of schizophrenia. Regardless of the clarity results of this study, this supposition warrants further endorsement.

Background Pharmacotherapies are widely used for smoking cessation. However, their effect on smoking cessation for people with alcohol dependence remains unclear. Objective This study aimed to explore the effects of pharmacotherapies on smoking cessation for people with alcohol dependence. Methods Five electronic databases were searched in January 2021 for randomized controlled trials (RCTs) reporting the use of pharmacotherapies to promote smoking cessation in people with alcohol dependence. The risk of bias was assessed using the Cochrane tool. RevMan version 5.3 was used to perform meta-analyses of the changes in smoking behavior, and the GRADE approach was used to assess the certainty of the evidence. Results Nine RCTs involving 908 smokers with alcohol dependence were identified. Eight RCTs were published in the United States, and one was from Canada. The risk of bias was rated as low in three studies and unclear in the remaining six. The results of the meta-analysis showed that, compared with the placebo group, Varenicline had a significant effect on short-term smoking cessation (three RCTs, OR = 6.27, 95% CI: [2.49, 15.78], p < 0.05, very low certainty). Naltrexone had no significant effect on smoking cessation in short-term or long-term observations (three RCTs, OR = 0.99, 95% CI: [0.54, 1.81], p = 0.97, moderate certainty), and Topiramate had no significant effect (two RCTs, OR = 1.56, 95% CI: [0.67, 3.46], p > 0.05, low certainty). Only one trial reported that Bupropion had no effect on smoking cessation. Conclusion Varenicline may have a positive effect on smoking cessation in people with alcohol dependence. However, Naltrexone, Topiramate, and Bupropion seem to have no clear effect on increasing smoking abstinence among drinkers. The small number of studies and the low certainty of evidence indicate that caution is required in interpreting the results.

Objectives One important group of people at higher risk from the COVID-19 pandemic are those with autoimmune conditions including rheumatoid arthritis/inflammatory bowel disease. To minimise infection risk, many people are now being switched from intravenous to subcutaneous biologics including biosimilars. A key question is how transition costs are viewed by clinicians. Design The survey was designed to understand the comparative economic issues related to the intravenous infusion vs subcutaneous biologic administration routes for infliximab. The survey focused on direct cost drivers/indirect cost drivers. Wider policy implications linked to the pandemic were also explored. Setting/Participants Semi structured telephone interviews were carried out with twenty key stakeholders across the NHS from clinical/pharmacy/commissioning roles. The interviews were undertaken virtually 5thApril-27thApril 2020 and included a semi-structured interview framework with questions across the two administration routes. Results From interview results a simple cost analysis was developed plus a qualitative analysis of reports on wider policy/patient impacts. Key findings included evidence of significant variation in infusion tariffs UK wide, with interviewees reporting that not all actual costs incurred are captured in published tariff costs. A cost analysis showed administration costs 50% that of infusion, with a most patients administering subcutaneous medicines themselves. Other indirect benefits to this route included less pressure on infusion unit waiting times and reduced risk of COVID-19 infection plus reduced patient costs. However, this was to some extent offset by increased pressure on home-care and community/primary care services. Conclusions Switching from infusion to subcutaneous routes is currently being driven by the COVID-19 pandemic in many services. A case for biologics (infusion vs subcutaneous) must be made on accurate real-world economic analysis. In an analysis of direct/indirect costs, excluding medicine acquisition costs, subcutaneous administration appears to be the more cost saving option for many patients even without the benefit of industry funded home-care.

Aim: To analyze developing infections after living donor hepatectomy (LDH) in living liver donors (LLDs). Methods: Demographic and clinical charecteristics of 1106 LLDs were retrospectively analysed in terms of whether postoperative infection development. Therefore, LLDs were divided into two group: with (n=190) and without (n=916) antimicrobial agent use. Results: The median age was 29.5 (min-max: 18-55). A total of 257 (23.2%) infection attacks (min-max: 1-8) was developed in 190 (17.2%) LLDs. The patients with infection that were longer intensive care unit (ICU) and hospital stays, higher hospital admissions, emergency transplantation, invasive procedures for ERCP, PTC biloma and abscess drainage, and the presences of relaparatomies and transcystic catheters. Infection attacks derived from a 58.3% hepatobiliary system, 13.2% urinary system, 6.6% surgical site and 5.8% respiratory system. The most common onset symptoms were fever, abdominal pain, nausea and vomiting. A total of 125 positive results was detected from 77 patients with culture positivity. The most detected microorganisms from the cultures taken are Extended-Spectrum β-lactamases (ESBL) producing Klebsiella pneumonia (16.8%) and Escherichia coli (16%), Methicillin-Resistant Staphylococcus aureus [(MRSA) (9.6%)], Methicillin-susceptible Staphylococcus aureus [(MSSA (9.6%)] and Pseudomonas aeruginosae (8.8%), respectively. The average number of ICU hospitalization days was 3±2 (min 1-max 30, IQR:1) and hospitalization days was 14±12 (min 3-max 138, IQR: 8). All infection attacks were successfully treated. No patients died due to infection or another surgical complication. Conclusion: Infections commonly observed infected biloma, cholangitis and abscess arising from the biliary system and other nosocomial infections are the feared complications in LLDs. These infections should be managed multidisciplinary without delay and carefully.

Background: Group B streptococcus (GBS), also name as Streptococcus agalactiae, is a gram-positive bacterium know for it capacity to colonises the vaginal and rectal areas of the mother and is a leading cause of neonatal mortality and morbidity. This study aimed at determining the prevalence, associated risk factors and antimicrobial susceptibility of GBS colonization among pregnant women attending antenatal care at Dschang District Hospital. Methods: This hospital-base cross-sectional study targeted pregnant women population attending hospitals for routine prenatal testing using a multistage sampling method. Pregnant women at 23.46 ± 6.44 weeks gestation completed a questionnaire and vaginal swabs were obtained for GBS analysis. Data were analysed using chi-squared (χ2) test or the Fisher’s exact test when appropriate and the multivariable logistic regression models. Results: The colonisation rate of GBS among pregnant women was 8.69%. Induce abortion (odds ratio [CI] = 3.09, 95% [1.56-6.21]), Spontaneaous abortions (OR= 2.82, 95% CI 1.14-7.29), Stillborn (OR [CI] = 7.75, 95% [2.61-21.71]), Fever (OR [CI] = 0.37, 95% [0.19-0.71]) and anemia (OR [CI] = 0.22, 95% [0.12-0.43]) were found to be influencing factors associated with GBS colonisation. Conclusion: Our findings suggest that none of the studied factors were significantly associated with GBS colonisation. Further longitudinal research is needed to establish the causal relationship and its biological mechanisms. Keys words: Group B Streptococcus, Prevalence, Risk Factors, Antimicrobial Susceptibility, Pregnant Women

Objectives: Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily transmitted from person to person via airborne droplets. It is unclear whether it can be shed into human milk and transmitted to a child via breastfeeding.We investigated the presence of SARS-CoV-2 RNA in human milk samples of 15 mothers with coronavirus disease 19(COVID-19) and in the throat swab samples of their infants. Methods: This is a prospective observational study in which breast milk samples were collected from 15 mothers with COVID-19. The presence of SARS-CoV-2 RNA in the whole human milk samples of the patients was investigated using RT-qPCR. All of the infants underwent a clinical follow-up during their 14-day isolation and their throat swab samples were tested for SARS-CoV-2 RNA. Results: Of 15 mothers with COVID-19, SARS-CoV-2 RNA was detected in milk samples from 4 mothers. The throat swab samples from these mothers’ infants were found to be positive for SARS-CoV-2 RNA. Three of the four mothers were breastfeeding. In addition, during the 14-day isolation, all but three of the mothers breastfed their infants. Of the 12 breastfed infants, while the test for SARS-CoV-2 RNA in throat swab samples was negative in six of the infants, the other six infants, who had mild COVID-19 symptoms, tested positive for SARS-CoV-2 RNA.Clinical outcomes of all mothers and infants were uneventful. Conclusion: To our knowledge, this is the first case series with the largest number of cases with SARS-CoV-2 RNA positivity in human milk samples of mothers with COVID-19. However, we believe that the benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants

It is commonly known that stored blood and blood products are heated before transfusion in order to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate content leaching into the blood and blood products and thereby causes greater conversion of di-(2-ethylhexyl) phthalate to mono (2-ethylhexyl) phthalate. However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension transfused via warming. In this study, we aimed to investigate the di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate content in blood following the ES transfusions administered by di-(2-ethylhexyl) phthalate -containing and di-(2-ethylhexyl) phthalate -free infusion sets. The study included 30 patients that were randomly divided into 2 groups with 15 patients each: group I underwent erythrocyte suspension transfusion via di-(2-ethylhexyl) phthalate -containing infusion sets warmed with blood-fluid warmers and group II underwent erythrocyte suspension transfusion via di-(2-ethylhexyl) phthalate-free infusion sets warmed with blood-fluid warmers. Di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate levels were measured both before and after transfusion. Di-(2-ethylhexyl) phthalate-free infusion sets led to no increase in the phthalate content, whereas di-(2-ethylhexyl) phthalate-containing infusion sets significantly increased the di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate levels, where the di-(2-ethylhexyl) phthalate level increased almost four times (p=0.001). Di-(2-ethylhexyl) phthalate-containing products lead to toxicity. Therefore, using di-(2-ethylhexyl) phthalate-free products may prevent toxicity in patients undergoing erythrocyte suspension transfusion.