Determining Post-COVID-19 Symptoms and Rehabilitation Needs in Hospitalized and Nonhospitalized COVID-19 Survivors with Tele-Assessment Methods.

Objectives: This study aimed to evaluate the post-COVID-19 symptoms, the severity of symptoms, and functional capacities seen in hospitalized and nonhospitalized COVID-19 survivors according to time periods (total 6, 1-3, and 3-6 months) by tele-assessment methods and to predict the need for periodic rehabilitation of COVID-19 survivors. Methods: Three hundred ninety-four COVID-19 survivors (50.18 ± 15.14 years) who were between 1 and 6 months after PCR(+) were included in the study, and their ongoing symptoms and the severity of these symptoms (0-10 points) were assessed with COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) Tool, and the 30-s Chair Stand Test (CST) was applied by tele-assessment methods. Results: In hospitalized and nonhospitalized survivors of COVID-19, 87% experienced at least one symptom within the first 6 months. The most prevalent symptoms were anxiety (47.7%), fatigue (46.7%), and muscle pain (45.7%). The most common symptom in the nonhospitalized group was fatigue (52.6%), whereas anxiety was 46.8% in the hospitalized group. The 30-s CST score of the nonhospitalized group was significantly higher than the hospitalized group (p < 0.001). Conclusions: In the first 6 months post-COVID-19, musculoskeletal problems, anxiety, fatigue, and muscle pain were observed to be the most prevalent symptoms, regardless of time, in hospitalized and nonhospitalized survivors. There was a serious decrease in their functional capacity. Priority should be given to psychiatric, cardiopulmonary, and musculoskeletal rehabilitation in post-COVID-19. Inclusion of hospitalized/nonhospitalized COVID-19 survivors in a comprehensive rehabilitation program tailored to their needs by following a comprehensive tele-assessment by a multidisciplinary team will reduce the "long COVID-19 syndrome." ClinicalTrials.gov Registration Number: NCT04900441.

Adverse effects of 900, 1800 and 2100 MHz radiofrequency radiation emitted from mobile phones on bone and skeletal muscle.

The goal of this study was to biomechanically and morphologically research both the impact of mobile phone like radiofrequency radiations (RFR) on the tibia and the effects on skeletal muscle through oxidative stress parameters. Fifty-six rats (200-250 g) were put into groups: healthy sham (n = 7), healthy RFR (900, 1800, 2100 MHz) (n = 21), diabetic sham (n = 7) and diabetic RFR (900, 1800, 2100 MHz) (n = 21). Over a month, each group spent two hours/day in a Plexiglas carousel. The rats in the experimental group were exposed to RFR, but the sham groups were not. At the end of the experiment, the right tibia bones and skeletal muscle tissue were removed. The three-point bending test and radiological evaluations were performed on the bones, and CAT, GSH, MDA, and IMA in muscles were measured. There were differences in biomechanics properties and radiological evaluations between the groups (p < .05). In the measurements in the muscle tissues, significant differences were statistically found (p < .05). The average whole-body SAR values for GSM 900, 1800 and 2100 MHz were 0.026, 0.164, and 0.173 W/kg. RFRs emitted from mobile phone may cause adverse effects on tibia and skeletal muscle health, though further studies are needed.

Role of Oxidative Stress in Obese and Nonobese PCOS Patients.

Objective: The aim of this study was to evaluate the relationship between the oxidant-antioxidant status, endothelial dysfunction, lipid metabolism, and metabolic syndrome risk in women with polycystic ovary syndrome (PCOS). Materials and Methods: Forty-five obese (BMI >30 kg/m2) woman diagnosed with PCOS in the study, forty-five nonobese (BMI <30 kg/m2) PCOS diagnosis working groups, and forty-nine healthy control groups were created with patients. Serum malondialdehyde (MDA) levels with antioxidant activities, such as SOD, GSH, GPx, and CAT activities, were measured by spectrophotometry. Results: There was a statistically significant difference in the mean serum MDA level in the obese PCOS group compared to the nonobese group and the control group (p < 0.001). When the antioxidant parameters, such as SOD, GPx, GSH, and CAT, were compared with the healthy control group, nonobese, and obese PCOS groups, the difference between the groups was statistically significant (p < 0.001). A positive correlation was observed between MDA and BMI, triglyceride, LDL, SBP, DBP, and HOMA-IR in the PCOS patient group. Conclusion: Oxidative stress and decreased antioxidant parameters in PCOS patients were correlated with hyperinsulinemia, hypertension, and dyslipidemia findings, and we think that this oxidative stress condition may contribute to metabolic syndrome and cardiovascular diseases in PCOS patients.

The levels of oxidative DNA damage and some antioxidants in chronic osteomyelitis patients: A cross-sectional study.

BACKGROUND: Osteomyelitis (OM) is a local or generalised infection of the bone and bone marrow which may be multifactorial in its causation. In this study, we aimed to determine oxidative DNA damage and antioxidant status of patients with chronic osteomyelitis. MATERIAL METHOD: In this study, patients with chronic osteomyelitis and healthy controls were compared for descriptive characteristics (age and gender) and serum levels of malondialdehyde (MDA), 8-hydroxy-2-deoxy guanosine and antioxidant enzymes catalase, glutathione and superoxide dismutase. RESULTS: This was a case-control study. About 5 mL of venous blood was collected for the estimation of biochemical parameters. This study comprised of 36 OM patients diagnosed, and 41 healthy ages (25-55 years) and sex-matched individuals. Antioxidant enzyme levels were significantly lower in patients with OM, whereas MDA and oxidative DNA damage levels were significantly higher. CONCLUSION: The results obtained from this study have shown that the oxidant-antioxidant balance is impaired in patients with chronic osteomyelitis. It also supports that chronic osteomyelitis has associated with oxidative DNA damage.

The effect of computed tomography on oxidative stress level and some antioxidant parameters.

BACKGROUND: X-rays are defined as ionizing radiation and hydrolyze the water, causing free radical formation. Oxidative stress is the damage that occurs in cells due to the lack of antioxidants, which detoxifies them, with the increased production of free radicals that occur during normal cellular metabolism. PURPOSE: To examine the acute effects of computed tomography (CT), i.e. ionizing radiation, on oxidative stress and antioxidant defense mechanisms. MATERIAL AND METHODS: The study included a total of 53 patients that were selected among the patients that underwent non-contrast full-body CT. Malondialdehyde (MDA) and reduced glutathione (GSH) levels and superoxide dismutase (SOD) and catalase (CAT) activities were investigated in blood samples taken from patients. RESULTS: The post-scan levels of MDA increased significantly while the post-scan levels of GSH, SOD, and CAT decreased significantly compared to their pre-scan levels. CONCLUSION: CT, which is a widely used X-ray imaging technique and has numerous known side effects, was found to increase the levels of MDA, which is an indicator of oxidative stress, and to decrease the levels of some antioxidants including GSH, SOD, and CAT.

Is ischaemic modified albumin a marker in osteomyelitis patients?

OBJECTIVE: To compare the levels of ischaemia modified albumin between osteomyelitis patients and healthy controls. METHODS: The cross-sectional prospective study was conducted at Van Yüzüncü Yil University, Van, Turkey, from May 2018 to May 2019, and comprised inpatients diagnosed with osteomyelitis, and healthy controls. Serum IMA concentrations were determined spectrophotometrically at 470nm wavelength. Serum ischaemia modified albumin levels were measured and compared between the patients and the controls. Data was analysed using SPSS 20. RESULTS: Of the 77 subjects, 37(48%) were patients and 40(52%) were controls. Serum ischaemia modified albumin level in patients was significantly higher than controls (p<0.05). There was a significant correlation between ischaemia modified albumin and C-reactive protein levels (p<0.05). CONCLUSIONS: Serum ischaemia modified albumin level in patients was significantly higher than controls (p<0.05).

Effects of bevacizumab administration on the hypoxia - induced pulmonary hypertension rat model.

BACKGROUND: Bevacizumab is a chemotherapeutic drug, which selectively binds to vascular endothelial growth factor (VEGF) and mainly inhibits angiogenesis and neovascularization. We aimed to study the possible effects of bevacizumab on right ventricular pressure (RVP), right ventricular hypertrophy, and VEGF, in hypoxia - induced pulmonary hypertension (PH) rat model. METHODS: 24 adult Wistar Albino rats were randomly divided into four groups: control group - saline; Bevacizumab Group; PH Group; PH + Bevacizumab Group. In hypoxia - induced model, 10% oxygen and 90% nitrogen were applied in a plexiglas box for eight days to PH Group and PH + Bevacizumab Group. On day eight, RVPs were measured directly from the heart, and then animals were sacrificed. Heart and lung tissues were examined, and Fulton index was measured. RESULTS: RVP, Fulton index, and tissue VEGF scores were significantly lower in PH + Bevacizumab group than PH group: median (ranges), RVP, mmHg, 37.8 (33.0-39.0) and 32.3 (28.0-35.0), p: 0.01; Fulton index: 0.30 (0.29-0.33) and 0.25 (0.24-0.26), p: 0.003; tissue VEGF scores: 5.1 (4.8-5.3) and 4.0 (3.8 4.1), p: 0.004, respectively. DISCUSSION: Bevacizumab, which is indeed an antineoplastic agent, might have a favorable effect on hypoxia - induced pulmonary hypertension.

Oxidant-antioxidant levels in patients with bladder tumours.

PURPOSE: We have aimed to determine whether oxidants-antioxidants play a role in the etiopathogenesis of bladder tumour by measuring their levels in the serums of patients with bladder tumour. MATERIAL METHOD: Thirty patients with bladder tumour with superficial bladder tumour and 27 normal healthy volunteers were included in the study. Four cc of venous blood was taken from these patients and volunteers in the control group and centrifuged at 5000 rpm for 10 minutes and divided into serum and plasma. The activities of xanthine oxidase, glutathione reductase, glutathione-s transferase, reduced glutathione and superoxide dismutase enzymes in serum were then measured spectrophotometrically. FINDINGS: Antioxidant parameters (glutathione-s-transferase, reduced glutathione, superoxide dismutase and glutathione reductase) in the serum of patients with bladder tumours were found statistically significantly lower than control group (p < .05). On the other hand, xanthine oxidase which is an oxidant indicator, was found significantly higher in patients with bladder cancer than control group (p < .05). CONCLUSION: Oxidative stress is effective in the etiopathogenesis of bladder tumour. We, therefore, believe that antioxidants are protective against bladder tumours and will be effective in the treatment of bladder tumours.

The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma

Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism (SCH) are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine (LT4) is the standard treatment method in differentiated thyroid carcinoma (DTC) follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC (n = 127), euthyroid-DTC (n = 66) and exogenous euthyroid-benign thyroid noduüle (BTN) who underwent thyroidectomy for benign thyroid pathology (n = 85) groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group (27.5%, n = 35 vs. 9.4%, n = 8) (P = 0.001). TSH levels and Beck anxiety inventory (BAI) scores were significantly negatively correlated(P = 0.009 r = ­0.16). Free T4 and BAI were significantly positively correlated (P = 0.04 r = 0.4). The groups were similar in terms of depression severity (P = 0.15). Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.

Determination of oxidative stress levels and some antioxidant enzyme activities in prostate cancer.

In this study, the antioxidant enzyme activities such as (SOD, GSH, and CAT) and malondialdehyde (MDA) level which is the end product of lipid peroxidation, were determined from the serum samples taken from patients diagnosed with prostate cancer Van Yuzuncu Yil University Medical Faculty of Educational Research and Training Hospital and Istanbul Bagcilar Education Research Hospital. The SOD, GSH, and CAT activity of patient groups was found significantly lower than the healthy control group in patients with prostate cancer (p < .05). Serum MDA level is found significantly high when compared to control groups. MDA levels increased in patients that suffer prostate cancer disorder. Whereas, firstly antioxidant enzymes activity of SOD, GSH and CAT have been decreased in control groups. Thus, we concluded that the cause of development of prostate cancer may be the result of an imbalance between the antioxidants and oxidative stress. As a result, SOD, CAT, GSH, and MDA may play an important role in the etiopathogenesis of prostate cancer.

Thyroid Nodules Are More Prevalent in Subjects with Colon Polyps, Independent of Insulin Resistance.

OBJECTIVE: Colorectal polyps and thyroid nodules are common disorders linked to hyperinsulinemia and metabolic syndrome (Mets). The direct association between these two diseases is not clear. We aimed to analyze the prevalence of thyroid nodules in subjects with and without colorectal polyps. The secondary aim was to establish the prevalence of Mets and its parameters in both disorders and to determine if insulin resistance and hyperinsulinemia are common underlying pathophysiological mechanisms. SUBJECTS AND METHODS: One hundred and five subjects with colorectal polyps (71 males, 34 females) and 68 controls (28 males, 40 females) were enrolled. The parameters of Mets together with TSH, insulin, low-density lipoprotein cholesterol, and homeostasis model for assessment of insulin resistance levels were calculated. We performed thyroid ultrasonography in all participants. RESULTS: The prevalence of Mets was similar in the colorectal polyp and control groups (37.1 vs. 37.3%, p = 0.982). The prevalence of Mets was nonsignificantly higher in subjects with a documented thyroid nodule compared to subjects without a thyroid nodule (43.0 vs. 32.6%, p = 0.205). The prevalence of thyroid nodules in subjects with colorectal polyps was significantly higher than in subjects without polyps (52.9 vs. 35.3%, p = 0.017). Compared to subjects with no colorectal polyps, we established a significant increase in the odds of having thyroid nodules (OR 2.05; 95% CI: 1.097-3.860, p = 0.017). The presence of colorectal polyps and age in the adjusted model were established to be independent risk factors for having thyroid nodules (p = 0.025 and p = 0.007, respectively). CONCLUSION: These results may support the presence of other common mechanisms in the development of these two pathologies other than insulin resistance and hyperinsulinemia.

Do Statins Affect Thyroid Volume and Nodule Size in Patients with Hyperlipidemia in a Region with Mild-to-Moderate Iodine Deficiency? A Prospective Study.

OBJECTIVE: The objective of this study was to assess the antiproliferative pleiotropic effects of statins on thyroid function, volume, and nodularity. SUBJECTS AND METHODS: One hundred and six hyperlipidemic patients were included in this prospective study. The 69 patients in the statin groups received atorvastatin (16 received 10 mg and 18 received 20 mg) or rosuvastatin (20 received 10 mg and 15 received 20 mg). The 37 patients in the control group, assessed as not requiring drugs, made only lifestyle changes. Upon admission and after 6 months, all patients were evaluated by ultrasonography as well as for lipid variables (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and thyroid function and structure. RESULTS: After 6 months, no differences in thyroid function, thyroid volume, the number of thyroid nodules, or nodule size were observed in the statin and control groups. In a subgroup analysis, total thyroid volume had decreased more in patients receiving 20 mg of rosuvastatin than that in the control group (p < 0.05). Maximum nodule size had decreased more in those receiving 10 mg of rosuvastatin (p < 0.05). CONCLUSIONS: Our results suggest an association between rosuvastatin treatment and smaller thyroid volume and maximum nodule diameter; this could be attributable to the antiproliferative effects of statin therapy on the thyroid.

Circulating irisin levels reflect visceral adiposity in non-diabetic patients undergoing hemodialysis.

BACKGROUND: Recent evidence suggests that increased visceral adiposity is a strong independent risk factor for cardiovascular death and all-cause mortality in hemodialysis (HD) patients. Irisin, which is a novel myokine, can play critical roles in diabetes and adiposity. The purpose of our study was to investigate whether serum irisin levels are associated with body mass index, waist circumference (WC), and total fat mass in non-diabetic patients undergoing maintenance HD. METHODS: This cross-sectional study included 108 non-diabetic HD patients and 40 age- and sex-matched apparently healthy subjects. Serum irisin concentrations were determined using an enzyme-linked immunosorbent assay. Body fat composition (TBF-410 Tanita Body Composition Analyzer) was measured and calculated. RESULTS: Serum irisin levels did not differ between HD patients and the healthy controls (523.50 ± 229.32 vs. 511.28 ± 259.74, p = 0.782). Serum irisin levels were associated with age (r = 0.314; p =0.006), HOMA-IR (r = 0.472; p = 0.003), WC (r = 0.862; p < 0.001), and total fat mass (r = 0.614; p < 0.001). In multivariate regression analysis, WC (ß = 1.240, p < 0.001) and total fat mass (ß = 0.792, p = 0.015) were the variables that were significantly associated with irisin concentrations (R(2 )=( )0.684, p < 0.001) after adjusting for confounding factors (age and HOMA-IR). CONCLUSIONS: These results suggest that serum irisin levels are related to visceral adiposity in non-diabetic HD patients.

The relationship between serum paraoxonase levels and carotid atherosclerotic plaque formation in Alzheimer's patients.

Low paraoxonase 1 (PON1) activity and carotid atherosclerosis have been suggested to be important risk factors for dementia. However, the studies to date could not fully clarify the relationship between PON1, carotid atherosclerosis and dementia. The present study aimed to measure carotid atherosclerosis and PON1 activity in Alzheimer's Disease and to evaluate the relationship between them. The study included 25 Alzheimer's patients and 25 control subjects, for a total of 50 individuals. The study measured the serum PON1 activity and other biochemical parameters and carotid atherosclerotic plaque values of the participants. The mean paraoxonase activity (31.06±2.31U/L) was significantly lower in the Alzheimer's group compared to the control group (59.05±7.05U/L) (P<0.001). Nonetheless, the carotid plaque values were significantly higher in the patient group (3.02±0.52mm) compared to the control group (1.84±0.45mm) (P<0.001). Furthermore, there was a negative correlation (81.0%) between PON1 activity and carotid plaque in the overall study group (P<0.05). Also serum homocystein level was higher in the patient group (22.15±7.05) compared to the control group (13.30±3.32). In conclusion, our findings show inverse association between PON1 activity and carotid atherosclerosis in Alzheimer patients: the lower the PON1 activity the more progressed the atherosclerotic process in AD.

Association between pulmonologists' tobacco use and their effort in promoting smoking cessation in Turkey: a cross-sectional study.

BACKGROUND: A strategy to reduce the number of smoking-related deaths is to encourage the involvement of health-care professionals in tobacco-use prevention activities and cessation counseling. Previous studies have shown that physicians' smoking status affects their efforts to provide smoking cessation counseling. This study investigates the association between pulmonologists' tobacco use and their efforts in promoting smoking cessation during their routine clinical practices in Turkey. METHODS: This cross-sectional study was performed among active members of the Turkish Thoracic Society (TTS) between June 2010 and February 2011 using an Internet-based self-administered questionnaire. Participants gave their written informed consent. The survey included questions about responders' sociodemographics, smoking status, and their routine clinical practice for smoking cessation counseling using the basic 5A's (Ask, Advise, Assess, Assist, and Arrange) of smoking cessation counseling. According to the total score for the 5A's protocol, smoking cessation counseling was dichotomized into low- and high-effort groups in promoting smoking cessation. Pearson's chi-square test and t-test were used to compare groups and logistic regression models for the research question, which was approved by the TTS Scientific Ethical Committee. RESULTS: The response rate was 41 % (N = 699/1701); 9.9 % were current smokers, and 72.7 % indicated that they provided high effort in promoting smoking cessation. A univariate analysis showed that noncurrent smokers were more likely to make a high effort than current smokers (odds ratio [OR], 1.82; 95 % confidence interval [CI]: 1.09-3.05; P = 0.02). However, there was no association between tobacco use (current smoking) and making high effort in promoting smoking cessation after controlling for the two confounders, sex and practicing in smoking cessation outpatient clinic (OR, 1.47; 95 % CI: 0.86-2.50; P = 0.1). CONCLUSIONS: Despite low response rate in our study and suspicions of underreporting, the smoking rate among the pulmonologists in our study was high. Non-current smokers were more likely to provide high effort in promoting smoking cessation compared to current smokers in univariate analysis. However, after controlling for the two confounders, sex and practising in SCOC, there was no association between tobacco use and providing high effort in promoting smoking cessation. Thus, improving medical school education, specialty training and post-graduate training on smoking cessation counseling may positively affect physician' effort in promoting smoking cessation.

Determination of oxidative stress level and some antioxidant activities in refractory epilepsy patients.

The aim of this study was to determine the levels of superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) in patients with refractory epilepsy. Serum superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) levels were determined using the spectrophotometer method. Refractory epilepsy patients' serum superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) levels were statistically significant compared to the healthy control group (p < 0.05). In conclusion, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) levels may play an important role in the etiopathogenesis of refractory epilepsy. This study was the first to investigate some parameters in refractory epilepsy disease.

Investigation of Oxidative Stress Level and Antioxidant Enzyme Activities in Operated and Nonoperated Patients with Spontaneous Intracerebral Hematoma.

BACKGROUND: Complex underlying mechanisms consisting of cytotoxic, excitotoxic, and inflammatory effects of intraparenchymal hemorrhage (ICH) are responsible for the highly detrimental effects on brain tissue. Oxidative stress also plays a significant role in brain damage after ICH; however, it is less important than other factors. In this study, we aimed to evaluate the oxidative stress parameters malondialdehyde (MDA) and antioxidant-reduced glutathione (GSH), superoxide dismutase (SOD), and catalase (CT) activities in operated and nonoperated patients with spontaneous ICH. METHODS: One hundred patients with spontaneous ICH and 100 healthy controls were included in this study. Within the indication, 50 of the 100 patients underwent decompressive surgery. MDA, GSH, SOD, and CT activities were measured in the serum obtained from the patients. RESULTS: SOD and CT levels were lower in the nonoperated group than in the operated and control groups. GSH was similar in the operated and nonoperated groups, but it was lower in the control group. However, MDA was higher in those who did not undergo surgery than in the other groups. CONCLUSIONS: In our study, MDA, an indicator of oxidative stress, was found to be lower, and CT and SOD activities were found to be higher in ICH patients who underwent decompression than in those who did not. This is the first study to present the correlations of MDA, SOD, CT, and GSH in operated and nonoperated patients with spontaneous ICH.

[A severe cutaneous anthrax case complicated with sepsis in Bursa, Turkey]. / Bursa'da sepsis klinik tablosu ile seyreden agir deri sarbonu olgusu.

Anthrax is a zoonotic infection caused by Bacillus anthracis. Although the incidence of disease has been decreasing in Turkey, it is still endemic in some regions of the country. The cutaneous form of disease is the most common clinical form, usually benign and rarely causes bacteriemia and sepsis. In this report, a case of cutaneous anthrax complicated with sepsis where B.anthracis was isolated from blood and wound cultures, was presented. A 53-years-old male living in Bursa province (northwestern Turkey), admitted to the emergency ward with high fever and a lesion on the right arm. His history indicated that he is dealing with livestock breeding and injured his arm during slaughtering of a sick lamb. The infection started as a black colored painless ulcer with 2 cm in diameter on his right elbow. The case was hospitalized and penicillin G therapy was started with the preliminary diagnosis of anthrax. Bullous lesions occurred around the wound, got necrosis and integrated with the first lesion. Gram stained slides from the bullous lesions revealed capsulated gram-positive bacilli under light microscope. Gram-positive bacilli were also isolated from bullous lesions and the blood cultures. The isolates were identified and confirmed as B.anthracis by conventional and molecular methods. Antibiotic susceptibility tests were performed by E-test method and the isolates were found to be susceptible to ampicillin, tetracyclin, tigecyclin, ciprofloxacin, levofloxacin, gentamycin, chloramphenicol, erythromycin, clarithromycin, vancomycin, linezolid, daptomycin and rifampicin. The lesion became surrounded by an extensive erythema and edema and expanded to the whole arm. Moxifloxacin was initiated due to the fact that clinical progress. During the second week of the therapy, a black colored scar was observed on the wound while hyperemia and edema regressed. The necrotic tissue debridated to accelerate healing and rest of the skin defect was planned for reconstruction. The patient who had septicaemia and disseminated cellulitis was discharged after his treatment continued for 14 days. Multiple-locus variable-number tandem repeat analysis method was used for molecular epidemiological investigation. The strains isolated from the patient were identified as genotype (GK) 43 classified in A3.a major cluster, and found to be identical to those strains isolated from animals in different provinces located at central and eastern Anatolia of Turkey. In conclusion, the risk of sepsis must be considered in patients with cutaneous anthrax with appropriate follow-up and treatment plan.

Microorganisms grown in urine cultures and antimicrobial resistance patterns: A randomised retrospective analysis from a tertiary hospital.

INTRODUCTION: Patients in intensive care units (ICU) are 5-7 times more susceptible to infection than other groups, which increases the prevalence of hospital-acquired infections and associated sepsis accounting for 60% of deaths. Gram-negative bacteria are the most common source of urinary tract infections that cause morbidity, mortality, and sepsis in the ICU. The aim of this study is to detect the most commonly grown microorganisms and antibiotic resistance in urine cultures in the intensive care units of our tertiary city hospital, which has more than 20% of the ICU beds in Bursa By this way, we suppose that we will contribute to surveillance studies in our province, our country. METHODOLOGY: Patients who were admitted to Bursa City Hospital adult ICU for various reasons between 15.07.2019 and 31.01.2021 and had growth in urine cultures were retrospectively screened. The urine culture result, growing microorganism, antibiotic used, and resistance status were recorded and analyzes were performed according to hospital data. RESULTS: Gram-negative growth was observed in 85.6% (n = 7707), gram-positive growth in 11.6% (n = 1045), and candida fungus growth in 2.8% (n = 249). Resistance to at least one antibiotic in urine cultures was observed for Acinetobacter (71.8), Klebsiella (51%), Proteus (47.95%), Pseudomonas (33%), E. coli (31%) and Enterococci (26.75%), respectively. DISCUSSION: Developing a health system leads to longer life expectancy, longer intensive care treatment, and more frequent interventional procedures. In terms of being a resource for empirical treatments, early initiation of empirical treatments to control the urinary tract infection disrupts the patient's hemodynamics and increases mortality and morbidity.

Maternal serum ischemia-modified albumin (IMA), total-sulphydryl concentrations, and some subclinic inflammatory markers in hyperemesis gravidarum (HG).

OBJECTIVE: This study investigates the relationship between Ischemia Modified Albumin and Total-Sulphydryl levels with some subclinical inflammatory markers in patients with hyperemesis gravidarum. MATERIALS AND METHODS: A total of 258 pregnant women, 137 with hyperemesis gravidarum and 121 low-risk pregnancies, were included in this case-control study. The patients were divided into three groups according to the severity of hyperemesis gravidarum as mild (n = 53), moderate (n = 41) and severe (n = 43). RESULTS: Serum Ischemia Modified Albumin levels were statistically different from the control group (P < 0.001). Among the subgroups, the highest Ischemia Modified Albumin value was observed in the severe hyperemesis gravidarum group, and the highest Total-Sulphydryl level was observed in the mild hyperemesis gravidarum group (P < 0.001). Serum potassium levels were higher in the control group (P < 0.001). While a negative correlation was observed between Ischemia Modified Albumin and Total-Sulphydryl, a positive correlation was observed in Platelet crit, C-reactive protein, and ketonuria. As the severity of the disease increases, Ischemia Modified Albumin, which is an oxidative stress factor, increases, and Total-Sulphydryl levels decrease (p < 0.001). Logistic regression analysis revealed that a one-unit increase in Ischemia Modified Albumin resulted in a statistically significant 1.9-fold increase in the risk of Severe hyperemesis gravidarum (OR 1.92, 95% CI 1.008-1.956; P = 0.01) CONCLUSION: This study shows that there is a condition in the pathophysiology of hyperemesis gravidarum, with an increase in Ischemia Modified Albumin and a decrease in Total-Sulphydryl levels, and oxidative stress occurs. It was important to detect increased Ischemia Modified Albumin and decreased antioxidant values in relation to the inflammatory factors that were effective in the severe hyperemesis gravidarum group.