Profiles of Primary Brain Abscesses and Their Impact on Survival: An International ID-IRI Study.

OBJECTIVES: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. METHODS: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. RESULTS: The patients had a mean±SD age of 46.8±16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI:1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). CONCLUSION: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.

Relationship between disease severity and myeloperoxidase in chronic viral hepatitis: a prospective study.

Aim: To measure serum myeloperoxidase (MPO) levels and to evaluate the relationship between this parameter and histological findings in chronic hepatitis B and C patients. Materials & methods: Three groups were formed: chronic hepatitis B, chronic hepatitis C and a control group. Serum MPO levels were determined by ELISA. Results: MPO level was found to be higher in both patient groups compared with the control group (p < 0.05). It was also higher in chronic hepatitis B and C patients with significant fibrosis compared with patients with mild fibrosis (p < 0.05). Conclusion: Our results show that increased MPO level can be used as an important noninvasive marker in both the early detection of liver fibrosis and the prediction of significant fibrosis.

The Course of Diabetic Foot Infection in Elderly Patients: Data of Patients From Turkey.

With the aging population, it is expected that diabetes and related complications will increase rapidly. The aim of this study was to examine the signs and symptoms of diabetic foot infection in elderly individuals. Patients with diabetic foot infection were grouped as mild, moderate, and severe. Patients aged <65 years and those who did not meet the diagnosis of diabetic foot infection were excluded from the study. Only the first applications of patients who applied to the hospital multiple times with diabetic foot infection diagnosis were evaluated. 314 patients were included in the study. The mean age of the patients was 71.5 (±12). The number of patients aged 75 and over was 125 (39.8%). Of the patients, 25.7% had mild, 61.7% moderate, and 12.4% severe clinical forms. 131 (41.7%) of the patients had osteomyelitis. Amputation was performed in 112 of the patients. Antibiotic treatment was given to 102 patients only. While 89 patients died, a significant correlation was found between all groups between amputation rate and mortality frequency and clinical severity of diabetic foot infection (P < .001). In our study, it was observed that the clinical severity of diabetic foot infection was more severe and the overall mortality rate was higher in geriatric patients. In light of all these data, it can be concluded that an early and comprehensive roadmap should be followed in geriatric patients with diabetic foot infection who have an increased risk of morbidity and mortality.

Betatrophin, elabela, asprosin, glucagon and subfatin peptides in breast tissue, blood and milk in gestational diabetes.

We investigated the presence of asprosin (ASP), betatrophin, elabela (ELA), glucagon and subfatin (SUB) in the milk of mothers with gestational diabetes mellitus (GDM) and compared their levels with blood levels. We also investigated whether these peptides are synthesized by the breast. We investigated 12 volunteer mothers with GDM and 14 pregnant non-GDM control mothers. The peptides were measured using ELISA and their tissue localization was determined using immunohistochemistry. Breast milk contains ASP, betatrophin, ELA, glucagon and SUB. The amount of the peptides ranged from highest to the lowest in colostrum, transitional milk and mature milk. The amount of peptides in the milk was greater than for blood. The peptides, except for ELA, were increased in milk and blood by GDM. Betatrophin and ELA are synthesized in the connective tissue of the breast. ASP, glucagon and SUB are synthesized in the alveolar tissue of the breast. These peptides in breast milk may contribute to the development of the gastrointestinal tract of newborns and infants.