Evaluation of Patients Treated in Intensive Care Due to COVID-19: A Retrospective Study.

BACKGROUND: The aim of this study is to report the demographic characteristics, clinical features, treatment protocols, comorbidities, imaging findings, prognosis and factors affecting mortality in critically ill patients with coronavirus disease 2019 (COVID-19) in the intensive care unit. MATERIALS AND METHODS: This retrospective cohort study consists of adult (≥18 years old) patients hospitalized in a tertiary hospital intensive care unit of with COVID-19. The independent effects of possible factors identified in previous analyzes on survival were analyzed using univariate and multivariate logistic regression analysis. RESULTS: The mean age of all patients was 70.2 ± 13.9 years. Of the 200 patients, 139 (69.5%) had died. White blood cells (19.2 ± 76.1 × 109 per L), neutrophil/lymphocyte ratio (15.4 ± 65.1), d-dimer (2,558.4 ± 4,574.2 ng/mL), ferritin (1,481.2 ± 4,447.4 µg/L) and C-reactive protein (CRP) (12.1 ± 11.9 mg/dL) levels were high at the time of admission. According to the results of univariate regression analysis; presence of additional disease (odds ratio [OR]: 3.837; P = 0.015), older age (OR: 1.027; P = 0.015), reverse transcriptase-polymerase chain reaction (RT-PCR) positivity (OR: 2.58; P = 0.019), higher heart rate (OR = 1.027; P = 0.028), higher APACHE II score (OR: 1.049; P = 0.012), higher sequential organ failure assessement (SOFA) score(OR: 1.479; P = 0.014), high d-dimer levels (OR: 3.180; P <0.001) and high CRP levels (OR: 1.035; P = 0.028) increases the risk of death. When patients with full data for all variables in the multivariate logistic regression model were evaluated; positive RT-PCR (OR=4.105; P = 0.005), older age (OR: 1.033; P = 0.024), higher heart rate (OR: 1.042; P = 0.006), higher (SOFA) score (OR: 1.477; P <0.001), high d-dimer levels at admission (OR: 3.459; P = 0.002) and diabetes mellitus (OR: 3.433; P = 0.035) increase the risk of death. CONCLUSION: Mortality of critically ill patients with COVID-19 pneumonia was high (69.5%). Older patients and acute respiratory distress syndrome were at higher risk of death. High SOFA score, high d-dimer at admission, and presence of diabetes mellitus were associated with high mortality.

Impact of COVID- 19 pandemic on antidepressants consumptions by wastewater analysis in Turkey.

The COVID-19 pandemic has been a major challenge worldwide, forcing countries to take restrictive measures beyond conventional methods in their fight against the spread of the disease. Followingly, many studies have been conducted on the effects of these measures on mental health. Wastewater-based epidemiology (WBE) was used in this study to monitor and estimate changes in antidepressant use under normal conditions (2019) and COVID-19 pandemic conditions (2020). Likewise, this study utilized wastewater-based epidemiology (WBE) to monitor and assess changing trends from the pre-pandemic period (2019) to COVID-19 pandemic conditions in antidepressant use (2020). Wastewater samples were collected from 11 cities in Turkey throughout six sampling periods covering the pre-pandemic and during-pandemic periods (June 2019-December 2020). Then, samples were analyzed via LC-MS/MS method. As a result, we observed that venlafaxine was the drug with the highest concentration (mean ± SD: 103.6 ± 112.1 mg/1000p/day). Moreover, city number 6 presented the highest venlafaxine use and the most dramatic increase during the pandemic period. Finally, this study revealed the potential of WBE to estimate the changing trends in mental health during the ongoing pandemic.

Determination of synthetic cannabinoids in randomly urine samples collected from probationers in Turkey.

Synthetic cannabinoids are a significant public health and safety problem that complicates drug tests with their ever-changing structures in our country and worldwide. The fact that most synthetic cannabinoids cannot be detected in biological samples by routine drug of abuse screening tests also causes an increase in the use of these substances in return. In this study, 500 urine samples of randomly selected probationers, analyzed with an enzymatic immunoassay test at Ege University Institute of Drug Addiction, Toxicology and Pharmaceutical Sciences (BATI) and tested negative, were then selected for retrospective analysis. Synthetic cannabinoids and their metabolites were quantitatively scanned in the collected urine samples via the liquid-liquid extraction method with the LC-MS/MS. Of the 500 studied urine samples, 108 (21.6%) were positive for 20 synthetic cannabinoids and their metabolites. The two most detected synthetic cannabinoids were 5F-NPB-22 (58%) and (S)-AB-FUBINACA (36%), and their mean concentrations were 72.94 ±â€¯47.51 ng/mL and 5.84 ±â€¯14.7 ng/mL, respectively. These results were also compared with national statistics from the general population. It resulted that immunoassay screening tests used in this study were insufficient, and urine samples should be studied in clinical and forensic cases with a validated chromatographic method.

New Psychoactive Substance 5-MeO-MiPT In vivo Acute Toxicity and Hystotoxicological Study.

BACKGROUND: The hallucinogenic tryptamine analog 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT) causes social problems worldwide. There are several studies on the metabolism; however, not more studies were found in the literature on acute toxicity. AIMS: To report the acute toxicity of 5-MeO-MiPT in mice, followed by quantitative toxicological analysis of blood and organs, hystotoxicological and immunohistochemical analysis of tissues and cells. STUDY DESIGN: Animal experiment Methods: In vivo experiments were performed using CD1 adult female mice (n=26). Animals were caged in 4 groups randomly. First group was a control (n=3). Second group was vehicle control (n=3) and injected 150 µL of blank solution (50% dimethyl sulfoxide in saline /0.9% of NaCl). While for acute toxicity experiments, 5-MeO-MiPT was added to a blank solution in order to obtain a dose of 0.27 mg/kg in 150 µL injection (n=10) and the last group were injected 2.7 mg/kg 5-MeO-MiPT in a 150 µL injection (n=10). Quantitative toxicological analysis, hystotoxicological and immunohistochemical analysis were performed. RESULTS: In the toxicological analysis, 5-MeO-MiPT was found negative in biological samples which were control, vehicle control, and 0.27 mg/kg dose mice groups. 5-MeO-MiPT was found 2.7-13.4 ng/mL in blood, 11-29 ng/g in kidney, 15.2-108.3 ng/g in liver, and 1.5-40.6 ng/g in the brain in 2,7 mg/kg injected group. In a low dose of the 5-MeO-MiPT liver section, compared with normal tissues, the difference in staining was statistically significant (p<0.0001). In high-dose of 5-MeO-MiPT, H-score showed that the increase in the number of Caspase-3 positive cells was significant compared to the control (p<0.05). In high-dose of 5-MeO-MiPT, intense Caspase-3 immunoreactivity was observed and the increase in the number of Caspase-3 positive cells compared to the control was statistically significant (p<0.05). In brain section, the statistics of the results obtained from the H-score showed that the increase in the number of Caspase-3 positive cells was significant compared to the control (p=0.0183). In vehicle control liver section, there were few Caspase-8 positive cells characterized by a light brown appearance (p=0.0117). In the high-dose 5-MeO-MiPT group, the numbers of positive cells at low and high doses of 5-MeO-MiPT group were statistically significant compared to the control (p<0.05). In the high-dose 5-MeO-MiPT group, Caspase-8 immunoreactivity was detected in the glomerular structures. Compared to control, the increase in Caspase-8 immunoreactivity was found to be statistically significant (p<0.05). CONCLUSION: Low-dose 5-MeO-MiPT did not cause any serious histopathological effects on the liver, kidney, and brain. High doses induce apoptotic cell death through caspase activity.

Estimation of alcohol and nicotine consumption in 11 cities of Turkey using wastewater-based epidemiology.

Alcohol and tobacco are the most frequently consumed substances in the world. Both are significantly associated with the increasing number of different diseases. Thus, monitoring nicotine and alcohol use is vital for public health planning and intervention strategies. This study aimed to calculate estimates of alcohol and nicotine use in 11 cities of Turkey using wastewater-based epidemiology. In 2019, daily composite wastewater samples from 18 wastewater treatment plants were collected for a week per season. The 24-h composite samples were collected via auto-samplers. Sample preparation for wastewater samples collected was done using liquid-liquid extraction and solid-phase extraction. Nicotine and ethyl sulfate (EtS) were analyzed using validated liquid chromatography-tandem mass spectrometry method. The estimated average nicotine consumption was 2.84 mg/p/day, and the average alcohol consumption was 3.46 ± 1.83 ml/p/day. The highest nicotine consumption was observed in Kayseri city; the highest alcohol consumption was calculated for Mersin city. In this study, the cigarette and alcohol consumption estimate obtained by wastewater-based epidemiology (WBE) was found to be higher than the Turkey Tobacco and Alcohol Market Regulatory Authority report. To our knowledge, this study is the most comprehensive one so far applied using WBE for 11 cities in Turkey and evaluates alcohol and nicotine use together.

Comparison of community illicit drug use in 11 cities of Turkey through wastewater-based epidemiology.

Wastewater-based epidemiology (WBE) is an ever-increasing discipline that enables researchers to track near-real-time data concerning the recreational use of illicit drugs. Community illicit drug use was estimated in eleven Turkish cities, using eighteen wastewater treatment plants, representing the metropolitan cities and rural areas with different socio-demographic characteristics. In this study, 24-h composite influent wastewater samples were collected for 1 week per season between March 2019 and December 2019. Heroin, amphetamine, methamphetamine, ecstasy, cocaine, and marijuana were covered as illicit drugs in this study. Solid-phase extraction, LC-MS/MS separation, identification, and quantification were used as the analytical methods. Overall results indicate that both cocaine and MDMA usage increased in all cities on weekends. More specifically, it was observed that the average amount of cocaine use regarding 11 cities was 14.7 mg/1000 person/day, while figures for other substances are as follows: 9.5 for amphetamine, 34.5 for methamphetamine, 38.4 for MDMA, 42.2 for heroin, and lastly 5412 mg/1000p/day for marijuana. This study holds the position of being the most comprehensive one conducted, considering spatial and temporal datasets on illicit drug consumption obtained via WBE in Turkey.

Estimating alcohol consumption by using wastewater-based epidemiology in Adana Province, Turkey.

Increased alcohol consumption, especially among young people, is a major concern in Turkey as it is around the world due to negative effects on public health and safety. Regarding this, it is pivotal to monitor and therefore control alcohol use in public. In this case, wastewater-based epidemiology (WBE), which is the in-depth analysis of wastewater and a relatively new method, can deliver complementary information concerning the abuse of different substances. The proven potential of the WBE approach offers new promises in the process of monitoring alcohol use, namely the monitoring of the levels of ethyl sulfate (EtS) as a urinary biomarker of alcohol consumption, and it is a powerful mean to estimate alcohol use at the community level. In this study, raw 24-h composite wastewater samples were collected from Seyhan and Yüregir wastewater treatment plants (WWTPs) in Adana Province for one week per season (October 2016-August 2017). The fast and validated analytical method was performed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) and therefore applied to the analysis of ethyl sulfate (EtS). Obtained concentration values were back-calculated, and regional and temporal social usage rates were determined. Higher values were calculated for both WWTPs on Sunday. Alcohol consumption in the region served by Seyhan WWTP was higher than Yüregir WWTP. The results showed that the levels of alcohol consumption during given periods in Adana ranged from 659.8 to 8998.7 mL/day/1000 per person with an average value of 4983.9 and 3924.2 mL/day/1000 inhabitant in Seyhan WWTP and Yüregir WWTP, respectively. This study shows that weekly and annual trends in alcohol consumption can be detected quickly from wastewater analysis.