Association between platelet indices and the severity of the disease and mortality in patients with COVID-19.

OBJECTIVE: The aim of the study was to determine the association between platelet indices and disease severity, and outcomes of the patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a secondary hospital. PATIENTS AND METHODS: 722 hospitalized patients who had positive rRT-PCR for SARS-CoV-2 and/or typical findings of COVID-19 at chest computed tomography (CT) were enrolled in this study. Initial platelet count (PLT) and indices, including mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), MPV/PCT, MPV/PLT, PDW/PLT, PDW/PCT on admission and the third day of hospitalization, and their relationship with disease severity and outcomes were evaluated retrospectively. RESULTS: The mean age of the patients was 57.2±15.6 years (range: 16-94) and male/female ratio was 1.22. 81.9% of the patients had moderate and 11.8% had severe disease. 1.8% of the patients had thrombocytopenia at admission. The patients transferred to the intensive care unit (ICU) had significantly lower baseline lymphocyte counts, PLT, PCT, and 3rd day lymphocyte counts when compared with the patients in wards. ICU patients also had higher baseline CRP, LDH, ferritin, MPV/PCT, MPV/PLT, PDW/PLT, PDW/PCT ratios, and 3rd day PDW, CRP, LDH, and ferritin levels than the patients in wards. Mortality was associated with lower baseline lymphocyte counts, PLT, PCT, 3rd day lymphocyte counts and PCT. Higher baseline CRP, LDH, ferritin, MPV/PCT, PDW/PLT, PDW/PCT and 3rd day CRP, LDH, ferritin, procalcitonin, PDW, MPV/PCT, PDW/PLT, and PDW/PCT ratios were also associated with poor prognosis. CONCLUSIONS: Platelet count and ratios were significantly associated with mortality in patients with COVID-19.

Effects of treadmill exercise on sexual behavior and reproductive parameters in chronically stressed-male rats.

Exposure to chronic stress stimulates the hypothalamic-pituitary-adrenal (HPA) axis and then simultaneously inhibits hypothalamic-pituitary-gonadal axis (HPG) axis activity. The inhibition formed by the HPA axis is the main mechanism of action of stress on reproductive function. HPG axis activity is known to be changed by various factors, including exercise. Exercise has been found to have a number of positive effects on sexual behavior, reproductive hormones, and sperm parameters in studies with animal models for many years. The main aim of this study is to investigate the effects of chronic treadmill exercise on chronically stressed-male rats' sexual behavior, reproductive hormones, and sperm parameters. A total of 40 sexually adult male rats were randomly and equally divided into four groups as control, stress, exercise, and stress+exercise. Animals in the exercise group were subjected to the chronic treadmill exercise (moderate intensity) for 33 days with a periodic increase in speed and duration. Animals in the stress group were exposed to restraint stress for 1 h, 2 h, and 3 h during the first, second and third 15 days respectively. Sexual behavior parameters, hormone measurements, and sperm parameters were evaluated. The main effects of chronic exercise on sexual behavior were centered on a significant increase in the ejaculation frequency (EF) in the stress+exercise group. Also, sperm concentration and motility in the stress group significantly decreased, and then sperm motility was improved by exercise in the stress+exercise group. In sum, our results show that chronic treadmill exercise may improve the adverse effects of chronic stress on sexual behavior and sperm parameters in male rats in terms of some parameters.

Comparison of 18F-FDG PET/CT and DW-MRI in assessment of neoadjuvant radiochemotherapy response in locally advanced rectal cancer patients. / Comparación de la PET/TC 18F-FDG y la DW-MRI en la evaluación de la respuesta a la radioquimioterapia neoadyuvante en pacientes con cáncer rectal localmente avanzado.

OBJECTIVE: Our aim is to evaluate if different metabolic parameters obtained by 18F-FDG PET/CT and diffusion weighted magnetic resonance imaging (DW-MRI) can aid in neoadjuvant radiochemotherapy (RCT) response assessment in locally advanced rectal cancer (LARC) patients. METHODS: Out of 20 LARC patients, who were planned to receive neoadjuvant RCT, 19 were included in this prospective study. Patients had 18F-FDG PET/CT and DW-MRI at initial staging, interim (2 weeks after onset of RCT) and after completion of RCT (post-therapy). Standardized uptake value (SUV) parameters (SUVmax, SUVmean, SUVpeak, SULpeak), metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) detected on PET images and apparent diffusion coefficient (ADC) values (for b=400 and b=1000s/mm2) obtained from DW-MRI were recorded. Postoperative tumor regression grade (TRG) was used as gold-standard, except for 2 patients who were under complete remission with non-operative management 19 months post-therapy and scored as responders. RESULTS: On interim PET/CT, no significant difference was found among PET parameters between responders and non-responders, whereas post-therapy SUVmax, SUVpeak, MTV, SULpeak, TLG (P=0.02, P=0.014, P=0.025, P=0.007, P=0.02, respectively) and initial MTV (P=0.034) were significantly lower in responders. ADC response index (RI) was higher in responders (interim P=0.026; post-therapy: P=0.018) and ROC analysis revealed that a threshold of ADC RI>41.6% for interim MRI and >44.6% for post-therapy MRI had sensitivity and specificity of 75.0% and 90.9%, respectively. CONCLUSIONS: While interim 18F-FDG PET/CT failed to predict therapy response during RCT, post-therapy PET could accurately differentiate responders. DW-MRI was found to be more promising in interim detection of RCT response.

Correction to: Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study.

In the original version of this article, Mustafa Sunbul was not included in the list of authors for this article. The name has been added accordingly.

Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter Infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study.

Cryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV infection worldwide, CM patients today may be admitted to hospitals with unknown HIV status, particularly in underdeveloped countries. The objective of this multicenter study was to analyze all types of CM cases in an aggregate cohort to disclose unfavorable outcomes. We retrospectively reviewed the hospitalized CM patients from 2000 to 2015 in 26 medical centers from 11 countries. Demographics, clinical, microbiological, radiological, therapeutic data, and outcomes were included. Death, neurological sequelae, or relapse were unfavorable outcomes. Seventy (43.8%) out of 160 study cases were identified as unfavorable and 104 (65%) were HIV infected. On multivariate analysis, the higher Glasgow Coma Scale (GCS) scores (p = 0.021), cerebrospinal fluid (CSF) leukocyte counts > 20 (p = 0.038), and higher CSF glucose levels (p = 0.048) were associated with favorable outcomes. On the other hand, malignancy (p = 0.026) was associated with poor outcomes. Although all CM patients require prompt and rational fungal management, those with significant risks for poor outcomes need to be closely monitored.

A new Multiple ANFIS model for classification of hemiplegic gait.

Neuro-fuzzy system is a combination of neural network and fuzzy system in such a way that neural network learning algorithms, is used to determine parameters of the fuzzy system. This paper describes the application of multiple adaptive neuro-fuzzy inference system (MANFIS) model which has hybrid learning algorithm for classification of hemiplegic gait acceleration (HGA) signals. Decision making was performed in two stages: feature extraction using the wavelet transforms (WT) and the ANFIS trained with the backpropagation gradient descent method in combination with the least squares method. The performance of the ANFIS model was evaluated in terms of training performance and classification accuracies and the results confirmed that the proposed ANFIS model has potential in classifying the HGA signals.

Polymerase chain reaction detection of Salmonella spp. in fecal samples of pet birds.

The aims of this study were 1) to determine the prevalence of Salmonella in clinically ill birds in aviaries in Ankara, Turkey, and 2) to compare conventional culture and polymerase chain reaction (PCR) for detection of Salmonella in feces from clinically ill pet birds. In the study, 185 fecal samples (feces and/or swabs) collected from the pet birds kept in the seven different aviaries in the city of Ankara were investigated for the existence of Salmonella spp. by bacterial isolation and PCR. The conventional isolation and identification methods were performed for Salmonella isolation from fecal cultures. Suspected colonies were confirmed with the Salmonella polyvalent O antiserum and serogrouped with Salmonella group-specific antiserum. PCR was performed after the fecal swabs were incubated for 18 hr in 10 ml of tetrathionate broth. Three (1.63%) out of 185 fecal samples were found to harbor Salmonella spp. by conventional identification tests and were found to belong to serogroup B. Five (2.7%) swab samples were found to harbor Salmonella DNA by PCR tests. As a conclusion, PCR following incubation of clinical samples in pre-enrichment broth seemed to be a fast and practicable method for Salmonella spp. diagnosis when compared to protracted labor-intensive conventional culture techniques.

Construction of a physical model of the human carotid artery based upon in vivo magnetic resonance images.

A method is described for construction of an in vitro flow model based on in vivo measurements of the lumen geometry of the human carotid bifurcation. A large-scale physical model of the vessel lumen was constructed using fused deposition modeling (a rapid prototyping technique) based on magnetic resonance (MR) images of the carotid bifurcation acquired in a healthy volunteer. The lumen negative was then used to construct a flow model for experimental studies that examined the hemodynamic environment of subject-specific geometry and flow conditions. The physical model also supplements physician insight into the three-dimensional geometry of the arterial segment, complementing the two-dimensional images obtained by MR. Study of the specific geometry and flow conditions in patients with vascular disease may contribute to our understanding of the relationship between their hemodvnamic environment and conditions that lead to the development and progression of arterial disease.