Comparison of standard prophylactic and preemptive therapeutic low molecular weight heparin treatments in hospitalized patients with COVID-19.

NTRODUCTION: Anticoagulant treatment approach in patients with COVID-19 is not well studied and not standardized. We aimed to compare the effects of standard prophylactic and pre-emptive therapeutic Low-Molecular-weight Heparin (LMWH) treatment approaches on mortality in patients with COVID-19. PATIENTS AND METHODS: This retrospective and single-centre study includes patients aged ≥ 18 years, who were diagnosed with COVID-19 and treated with LMWH during the hospital stay. Therapeutic dose of LMWH was defined as 1 mg/kg subcutaneously twice daily and prophylactic dose of LMWH was defined as 40 mg subcutaneously once daily. RESULTS: Among the 336 patients diagnosed with COVID-19 pneumonia, 115 patients, who received LMWH were included in the study. The mean age was 58.6 ± 13.3 and 58 (50.4 %) of the patients were male. Sixty-nine (60 %) of the patients were treated with prophylactic and 46 (40 %) therapeutic LMWH.In-hospital mortality was not different between patients treated therapeutic LMWH and prophylactic LMWH by the multivariate regression analysis (OR=2.187, 95% CI 0.484-9.880, p=0.309) and the propensity score modelling (OR=1.586, 95% CI 0.400-6.289, p=0.512.)CONCLUSION: Clinicians should consider the potential risks and benefits of standard prophylactic and pre-emptive therapeutic LMWH. Therefore, anticoagulant therapy should be individualized in patients with COVID-19 (Tab. 3, Ref. 28).

Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study.

Mass gatherings pooling people from different parts of the world-the largest of which is to Mecca, Saudi Arabia, for Hajj-may impose risks for acquisition and dissemination of infectious diseases. A substantial number of pilgrims to Hajj and Umrah are Turkish citizens (456,000 in 2014) but data are lacking on scale of the problem. We did a retrospective cross-sectional multicenter study in Turkey to explore the range of infections among inpatients who had recently returned from the Arabian Peninsula. Our inclusion criteria were patients who had acquired an infection during their trip to an Arabian Peninsula country, or who became symptomatic within 1 week of their return. The data were collected retrospectively for January 1, 2013 and March 1, 2015. 185 Turkish patients were recruited to the study across 15 referral centers with travel associated infectious diseases after returning from Arabian Peninsula countries (predominantly Saudi Arabia 163 [88.1 %] for religious purposes 162 [87.5 %]). Seventy four (40.0 %) of them were ≥ 65 years old with numerous comorbidities including diabetes (24.3 %) and COPD (14.1 %). The most common clinical diagnosis was respiratory tract infections (169 [91.5 %]), followed by diarrheal diseases (13 [7 %]), and there was one case of MERS-CoV. Patients spent a median of 5 (3-7) days as hospital inpatients and overall mortality was 1.1 %. Returning travellers from the Arabian Peninsula present as inpatients with a broad range of infectious diseases similar to common community acquired infections frequently seen in daily medical practices in Turkey.

Evolution of metal pollution in the golden horn (Turkey) sediments between 1912 and 1987.

The Golden Horn is a heavily polluted water body in a large metropolitan area with a population of approximately 10 million. A 3-m long undisturbed core sample was collected in the Golden Horn, from research vessel RV Knorr, during the third leg of the joint Turkish--American Black Sea expedition in 1989. The core was sliced and dated using the 210Pb isotope technique. The bottom of the core corresponds to the year 1912. Each slice was analysed for major, minor and trace elements by inductively coupled plasma emission spectrometry (ICP). The masses of the measured elements can account for approximately half of the sediment mass. The lithophilic elements Li, K, Rb, Mg, Ca, Ba, Al, La, Ti, V, Mn, Fe, Co and Ni account for more than 90% of the elemental mass and do not show any change in their concentrations between 1912 and 1987. Although anthropogenic elements Mo, Zn, Cr, Cu, Ag, and Cd account for a minute fraction of the elemental mass, their concentrations increase along the core, signifying human influence on chemical composition of the Golden Horn Sediments. Lead was enriched at the bottom of the core suggesting pollution of Golden Horn sediments by this element even at the beginning of the century, but observed concentrations of the remaining anthropogenic elements, at the bottom of the core, can be explained by sedimentary material. Concentrations of pollution-derived elements do not change significantly between 1912 and 1950, but their concentrations increase sharply in the second half of the century. A factor analysis applied to the data set has shown that the inorganic fraction of the Golden Horn sediments includes crustal, marine and two anthropogenic components. One of the anthropogenic components is attributed to the discharges from an iron and steel plant. The second anthropogenic component, which accounted for a larger fraction of system variance, is due to discharges from industries, particularly metalwork plants.

Effects of Desialylation on Chemoattractant Induced Chemotaxis.

The amount of sialic acid on the surface of the neutrophil influences its ability to interact with other cells. Neutrophil activation with various stimuli mobilizes intracellular sialidase to the plasma membrane where it cleaves sialic acid from cell surfaces. Since enhanced neutrophil adherence, spreading, deformability and motility each are associated with surface desialylation and critical to neutrophil diapedesis, we studied the role of sialic acid on neutrophil chemotaxis with interleukin-8 (IL-8), leukotriene B4 (LTB4), fMet-Leu-Phe (fMLP) and complement 5a in vitro. Migration of NANase-treated neutrophil across 3 µ pore size polycarbonate membranes was decreased in response to IL-8 and LTB4 but not to fMLP and complement 5a. These findings suggest that sialic acid content of receptors have a key role on chemoattractant-receptor binding and may be a novel strategy for limiting the inflammatory response.

Evaluation of tularaemia courses: a multicentre study from Turkey.

In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with ß-lactam/ß-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.