COULD COVID-19 TRIGGER TYPE 1 DIABETES? PRESENTATION OF COVID-19 CASE PRESENTED WITH DIABETIC KETOACIDOSIS.

COVID-19 is a viral disease that is recognized now as a pandemic by the World Health Organization. It is known that some viral infections may trigger autoimmune diseases. It has been revealed that COVID-19 may also lead to the pathogenesis of some autoimmune diseases, including Type 1 DM (T1DM) and autoimmune thyroid diseases. Here, we aimed to present a young female patient with COVID-19, who we followed up in our clinic, who presented with diabetic ketoacidosis (DKA), and developed Hashimoto's disease during the treatment process. In order to emphasize that COVID-19 may trigger the emergence of T1DM, that it may mask nonspecific DKA symptoms like nausea and vomiting, that it may cause delay in diagnosis of DKA, and also to emphasize the importance of evaluating other autoimmune diseases accompanying COVID-19, we found it appropriate to present this case.

Evaluation of whether the ACE gene I/D polymorphism constitutes a risk factor for chronic obstructive pulmonary disease in the Turkish population.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that occurs as a result of the normal inflammatory process to protect against harmful irritants and chemicals. Another physiological regulatory process, the renin angiotensin system (RAS), plays an important role in the pathology of many diseases. Angiotensin converting enzyme (ACE) is a key enzyme of RAS. We investigated the frequency of the ACE gene I/D polymorphism in patients with COPD in Turkey. This study was performed on 47 unrelated patients with COPD and 64 healthy subjects. DNA samples were isolated from peripheral blood, and ACE DNA was amplified by polymerase chain reaction. The frequencies of ACE genotypes were 27.7, 55.3, and 17% for DD, ID, and II in the COPD group, respectively, and 43.8, 43.8, and 12.4% in the control group. There was no statistically significant difference between groups (X(2) = 3.078; df = 2; P = 0.220). The distributions of ACE gene D alleles were 38.2% (N = 52) in the COPD group and 61.8% (N = 84) in the control group; and those of I alleles were 48.8% (N = 42) in the COPD group and 51.2% (N = 44) in the control group. There was no statistically significant difference between groups for allele frequency (X(2) = 2.419; df = 2; P = 0.120). We believe these results can be useful for large-scale population genetic research considering the frequency of the ACE gene variation in COPD patients in the Turkish population.

Associating IDH and TERT Mutations in Glioma with Diffusion Anisotropy in Normal-Appearing White Matter.

BACKGROUND AND PURPOSE: IDH and TERT mutations might infiltratively manifest within normal-appearing white matter with specific phenotypes such as microstructural changes undetectable by standard MR imaging contrasts but potentially associable with DTI variables. The aim of this retrospective glioma study was to statistically investigate IDH and TERT associations and classifications with DTI reported microstructure in normal-appearing white matter. MATERIALS AND METHODS: Retrospective data from patients imaged between March 2012 and February 2016 were analyzed by grouping them as IDH-TERT subgroups and by IDH and TERT mutation status. DTI variables in the IDH-TERT subgroups were first identified by the Kruskal-Wallis test, followed by Dunn-Sidák multiple comparisons with Bonferroni correction. IDH and TERT mutations were compared with the Mann-Whitney U test. Classification by thresholding was tested using receiver operating characteristic analysis. RESULTS: Of 170 patients, 70 patients (mean age, 43.73 [SD, 15.32] years; 40 men) were included. Whole-brain normal-appearing white matter fractional anisotropy (FA) and relative anisotropy (RA) (P = .002) were significantly higher and the contralateral-ipsilateral hemispheric differences, ΔFA and ΔRA, (P < .001) were significantly lower in IDHonly patients compared with TERTonly, with a higher whole-brain normal-appearing white matter FA and RA (P = .01) and ΔFA and ΔRA (P = .002) compared to double positive patients. Whole-brain normal-appearing white matter ADC (P = .02), RD (P = .001), λ2 (P = .001), and λ3 (P = .001) were higher in IDH wild-type. Whole-brain normal-appearing white matter λ1 (AD) (P = .003), FA (P < .001), and RA (P = .003) were higher, but Δλ1 (P = .002), ΔFA, and ΔRA (P < .001) were lower in IDH mutant versus IDH wild-type. ΔFA (P = .01) and ΔRA (P = .02) were significantly higher in TERT mutant versus TERT wild-type. CONCLUSIONS: Axial and nonaxial diffusivities, anisotropy indices in the normal-appearing white matter and their interhemispheric differences demonstrated microstructural differences between IDH and TERT mutations, with the potential for classification methods.

Effectiveness of air purifiers in intensive care units: an intervention study.

BACKGROUND: Effective design and operation of intensive care unit (ICU) ventilation systems is important to prevent hospital-acquired infections. Air purifiers may contribute. AIMS: To detect the number and types of micro-organisms present in the air and on high-touch surfaces in ICUs, and to evaluate the effectiveness of air purifiers in reducing the microbial load and thus the rate of nosocomial infections in ICUs. METHOD: This intervention study was conducted in two similar ICUs between May to November 2020. Novaerus air purifiers were located in the intervention ICU for 2 months. Routine cleaning procedures and high-efficiency particulate air filtration continued in the control ICU as well as in the intervention ICU. After 2 months, the air purifiers were moved to the other ICU for the next 2 months to reduce any possible bias in the results. Air and surface samples were evaluated. FINDINGS: Evaluation of changes in the intervention ICU over time revealed a significantly lower colony concentration in the air and on surfaces on Day 60 compared with Day 1 (Pair<0.001 and Psurface<0.001). There was a significant positive correlation between the number of colonies detected and the rate of hospital-acquired infections in the intervention ICU (r=0.406, P=0.049) and in the control ICU (r=0.698, P=0.001). CONCLUSION: Using air purifiers in addition to heating, ventilation and air conditioning systems in hospitals may be an effective way to reduce the microbial load in the air and on surfaces, and thus hospital-acquired infections.

Effects of human amniotic fluid on costal cartilage regeneration (an experimental study).

OBJECTIVE: After surgical correction of thoracic wall deformities, promoting neochondrogenesis in the perichondrial bed is very important for obtaining a flexible chest wall. In this experimental study, we aimed to investigate the effects of human amniotic fluid on cartilage regeneration in the costal perichondrial bed in a rabbit model. METHODS: Fifty-four adult New Zealand rabbits were divided into three groups, with 18 rabbits in each group. The third and fifth costal cartilages were excised totally on the right side and partially excised on the left side in all groups. Group 1 served as controls. All rabbits in group 1 underwent closure of the perichondrium of the third costal cartilage and closure of the perichondrium of the fifth costal cartilage with reimplantation of reshaped cartilage into the fifth costal perichondrial bed. Rabbits in group 2 underwent closure of the perichondrium of the third and fifth costal cartilages after the administration of human amniotic fluid into the perichondrial bed. Group 3 rabbits received both human amniotic fluid and underwent cartilage reimplantation. The third and fifth costal perichondriums in group 3 rabbits were closed after the administration of human amniotic fluid and the reimplantation of reshaped cartilages. Rabbits were sacrificed at two, eight and 12 weeks after operation. RESULTS: Numerical scores for the right perichondrial bed were significantly higher for group 2 compared to group 1 ( P < 0.05). But the difference was not significant for the left perichondrial bed ( P > 0.05). The diameter of chondrogenesis also did not differ significantly between left and right perichondrial bed for all groups. CONCLUSION: Our study shows that administration of human amniotic fluid into the perichondrial bed increases chondrogenesis in adult rabbits, an important finding which may contribute to improving chest wall flexibility after the surgical correction of pectus excavatum.

Surgical management of bronchiectasis: a collective review of 339 patients with long-term follow-up.

OBJECTIVE: The incidence of bronchiectasis has decreased significantly in developed countries due to successful control of childhood infections. However, the surgical treatment of this disease still plays an important role in thoracic surgical practice in underdeveloped and developing countries. The aim of this retrospective study was to present our surgical experience in patients with bronchiectasis, including our surgical treatment strategies and the results of long-term follow-up. METHODS: A retrospective chart review was conducted of 339 patients who underwent surgical resection for bronchiectasis between January 1992 and December 2009. The patients' demographic features, the symptoms, etiologies and resection types, morbidity, mortality and outcomes after surgical management were analyzed. RESULTS: There were 301 (88.8 %) male and 38 (11.2 %) female patients; the average patient age was 22.4 years (range 15-50 years). The most common presenting symptoms were productive cough in 197 (58.1 %) patients. There were 21 (6.2 %) asymptomatic patients. Two hundred and thirty of the 339 patients (67.8 %) had had previous medical therapy before admission to our department. The most common etiology of bronchiectasis was childhood infections in 101 (29.8 %) patients. In most patients, bronchiectasis was found on the left side (n = 225, 66.4 %). Thirty-five patients underwent a second operation for bilateral disease. There were two (0.6 %) early postoperative mortalities including one myocardial infarction and one respiratory insufficiency. Complications occurred in 43 patients (12.7 %). The median follow-up was 13.6 months. Symptoms disappeared in 201 patients (71 %), and 66 patients (23.3 %) experienced an improvement, while 16 patients (5.7 %) continued to be symptomatic. CONCLUSION: Although improvements in medical treatment have resulted in a significant decrease in the number of patients with bronchiectasis, surgical management is still very important in developing countries. Surgical resection can be performed with acceptable morbidity and mortality rates. The aim should be the resection of all involved bronchiectatic sites, even in patients with bilateral disease, if the pulmonary reserve is adequate.

A 6.2-cm tracheal segment resection for tracheal post-intubation stenosis.

Post-intubation tracheal stenosis is a clinical problem caused by regional ischemic necrosis of the airway. The outcome of a long tracheal segment resection (6.2 cm) in a patient with post-intubation stenosis is presented.

Primary pulmonary paraganglioma with Hodgkin's lymphoma.

Extra-adrenal paragangliomas are uncommon tumors arising from neuroectodermal-derived paraganglionic tissue. There are very few case reports on primary pulmonary paraganglioma in the literature. We present the case of a 21-year-old man who was treated with chemotherapy for Hodgkin's lymphoma. Only a partial response was noted so he underwent additional chemotherapy and involved field radiotherapy. PET-CT showed pathological activity in the lung parenchyma. Subsequent bronchoscopic biopsy showed paraganglioma and the patient underwent a left lower lobectomy.

Fracture resistance of thin-walled roots restored with different post systems.

AIM: To compare the fracture resistance of thin-walled roots after restoration with different types of post systems. METHODOLOGY: One hundred and sixty-five decoronated maxillary central incisors were root filled and randomly assigned to three groups with respect to the remaining dentine thickness of root (1.0 mm, 1.5 mm, 2.0 mm). Each group was randomly divided into five equal subgroups. The subgroups were restored with one of the following post systems: polyethylene woven fibre (R), composite resin cured by light-transmitting post + glass fibre post (L), electrical glass fibre post (E), composite corono-radicular restoration (C) and cast metal post (M). Standard cores were constructed using composite resin in the first four groups. The samples were subjected to a gradually increasing force (1 mm min(-1)). The force required to fracture was recorded. The data was analysed with anova and Tukey test (P = 0.05). RESULTS: The cast metal post group had the highest fracture strength (P < 0.001). There was no significant difference in fracture resistance between the other four groups. Fracture resistance was affected largely by the remaining dentine thickness in fibre post groups; however, the difference was not significant. On the contrary in the cast metal post group load failure was inversely influenced by axio-proximal dimension of dentine walls. CONCLUSION: The cast post group had a higher fracture strength than resin groups. The force required to fracture the roots was similar for all fibre post systems and for all dentine thicknesses.

Ozone partially prevents diabetic neuropathy in rats.

Neuropathy is one of the most common complications of diabetes mellitus. Although the beneficial effects of good blood glucose control on diabetic neuropathy are known, this control cannot completely prevent the occurrence and progression of diabetic neuropathy. The aim of this study was to investigate whether ozone prevents diabetic neuropathy. 36 adult female Sprague-Dawley rats were randomly divided into 6 groups (n=6): control (C), ozone (O), diabetic (D), ozone-treated diabetic (DO), insulin-treated diabetic (DI), and ozone- and insulin-treated diabetic (DOI). Diabetes was induced by a single injection of streptozotocin (60 mg/kg, intraperitoneal [i.p.]), after which insulin was administered (3 IU, i.p.) to the DI and DOI groups for 28 days, and 1.1 mg/kg (50 µg/ml) ozone was given to the O, DO, and DOI groups for 15 days. 4 weeks after the induction of diabetes, the nerve conduction velocity (NCV), amplitude of the compound action potential (CAP), total oxidant status (TOS), and total antioxidant status (TAS) were measured, and the oxidative stress index (OSI) was calculated. The NCV, amplitude of CAP, and TAS of the DI and DOI groups were higher than those of the D group; the amplitudes of CAP and TAS of the DO group were higher than those of the D group; and the TOS and OSI of the DO, DI, and DOI groups were lower than those of the D group. These findings indicate that ozone partially prevents diabetic neuropathy in rats. It appears that the preventive effects of ozone are mediated through oxidant/antioxidant mechanisms.

Adenocarcinoma arising in a retained esophageal remnant.

Fistulation between the trachea and an infected mucocele arising from an excluded retained esophageal segment is an interesting and unusual complication of esophageal bypass surgery. We present such a case in which there was also malignant transformation in the cyst wall, manifested by invasive adenocarcinoma and widespread high-grade glandular dysplasia.

The long-term morbidity of pleuroperitoneal shunts in the management of recurrent malignant effusions.

OBJECTIVE: Over the last 15 years we have managed patients with malignant pleural effusion, using a single procedure with thoracoscopy and talc pleurodesis or shunt as appropriate. Talc pleurodesis remains our primary treatment option but in those patient shown to have the 'trapped lung syndrome', in whom pleurodesis would fail, we have been using a pleuroperitoneal shunt. METHODS: This retrospective review was undertaken to evaluate the mortality and morbidity of pleuroperitoneal shunts in the management of malignant pleural effusions and to assess their long-term results. Three hundred and sixty patients were treated for malignant effusions during the period 1983-1998, 160 (44.4%) of whom had a pleuroperitoneal shunt inserted. There were no intraoperative deaths and the hospital mortality was three patients (1.87%). Follow up was available for 88.1% of patients. The median survival of all malignant cases was 7.7 months (range 1-72 months). Mesothelioma patients survived somewhat longer with a median survival of 10.1 months. RESULTS: Shunt complication occurred in 21 patients (14.8%). Twelve patients developed shunt occlusion, requiring revision in five and replacement in seven. The shunt was removed in eight patients due to skin erosion in one patient and infection in seven patients. The distal limb of shunt was broken in one patient and the shunt was replaced. One patient developed malignant seeding along the chest wall at the site of shunt insertion but there were no incidences of peritoneal deposits. Effective palliation was achieved in 95% of patients. CONCLUSIONS: Pleuroperitoneal shunt insertion provides effective and safe palliation for malignant pleural effusion when associated with the 'trapped lung syndrome'. There are however complications which require revision or shunt removal. There is no evidence that peritoneal deposits result from pleuroperitoneal shunting.

The use of absorbable material in correction of pectus deformities.

Various techniques have been described for correction of the congenital anterior chest wall deformities. We described a new technique in which 33 patients were used in correction of those deformities. In this new technique we used the resorbable copolymer plaque and polymer screw for the fixation of the sternum. We have obtained excellent results in one-year follow up period. This technique was developed to avoid a second operation, which usually requires for removal of the metal support. Resorption of copolymer plaques and polymer screws are completed at the end of the first year.

Entrapment of white-rot fungus Trametes versicolor in Ca-alginate beads: preparation and biosorption kinetic analysis for cadmium removal from an aqueous solution.

The biosorption of cadmium ions onto entrapped Trametes versicolor mycelia has been studied in a batch system. The maximum experimental biosorption capacities for entrapped live and dead fungal mycelia of T. versicolor were found as 102.3 +/- 3.2 mg Cd(II) g(-1) and 120.6 +/- 3.8 mg Cd(II) g(-1), respectively. Biosorption equilibrium was established in about 1 h and biosorption was well described by the Langmuir and Freundlich biosorption isotherms. The change in the biosorption capacity with time was found to fit the pseudo-second-order equation. Since the biosorption capacities were relatively high for both entrapped live and dead forms, those fungal forms could be considered as suitable biosorbents for the removal of cadmium in wastewater-treatment systems. The biosorbents were reused in three consecutive adsorption/desorption cycles without a significant loss in the biosorption capacity.

Comparative biosorption of mercuric ions from aquatic systems by immobilized live and heat-inactivated Trametes versicolor and Pleurotus sajur-caju.

Trametes versicolor and Pleurotus sajur-caju mycelia immobilized in Ca-alginate beads were used for the removal of mercuric ions from aqueous solutions. The sorption of Hg(II) ions by alginate beads and both immobilized live and heat-killed fungal mycelia of T. versicolor and P. sajur-caju was studied in the concentration range of 0.150-3.00 mmol dm(-3). The biosorption of Hg(II) increased as the initial concentration of Hg(II) ions increased in the medium. Maximum biosorption capacities for plain alginate beads were 0.144+/-0.005 mmol Hg(II)/g; for immobilized live and heat-killed fungal mycelia of T. versicolor were 0.171+/-0.007 mmol Hg(II)/g and 0.383+/-0.012 mmol Hg(II)/g respectively; whereas for live and heat-killed P. sajur-caju, the values were 0.450+/-0.014 mmol Hg(II)/g and 0.660+/-0.019 mmol Hg(II)/g respectively. Biosorption equilibrium was established in about 1 h and the equilibrium adsorption was well described by Langmuir and Freundlich adsorption isotherms. Between 15 and 45 degrees C the biosorption capacity was not affected and maximum adsorption was observed between pH 4.0 and 6.0. The alginate-fungus beads could be regenerated using 10 mmol dm(-3) HCl solution, with up to 97% recovery. The biosorbents were reused in five biosorption-desorption cycles without a significant loss in biosorption capacity. Heat-killed T. versicolor and P. sajur-caju removed 73% and 81% of the Hg(II) ions, respectively, from synthetic wastewater samples.

Procion Green H-4G immobilized poly(hydroxyethylmethacrylate/chitosan) composite membranes for heavy metal removal.

The effective removal of toxic heavy metals from environmental samples still remains a major topic of present research. Metal-chelating membranes are very promising materials as adsorbents when compared with conventional beads because they are not compressible, and they eliminate internal diffusion limitations. The purpose of this study was to evaluate the performance of a novel adsorbent, Procion Green H-4G immobilized poly(hydroxyethylmethacrylate (HEMA)/chitosan) composite membranes, for the removal of three toxic heavy metal ions, namely, Cd(II), Pb(II) and Hg(II) from aquatic systems. The Procion Green H-4G immobilized poly(hydroxyethylmethacrylate/chitosan) composite membranes were characterized by elemental analysis, scanning electron microscopy and Fourier transform infrared (FTIR) spectroscopy. The immobilized amount of the Procion Green H-4G was calculated as 0.018+/-0.003 micromol/cm(2) from the nitrogen and sulphur stoichiometry. The adsorption capacity of Procion Green H-4G immobilized poly(hydroxyethylmethacrylate/chitosan) composite membranes for selected heavy metal ions from aqueous media containing different amounts of these ions (30-400mg/l) and at different pH values (2.0-6.0) was investigated. The amount of Cd(II), Pb(II) and Hg(II) adsorbed onto the membranes measured at equilibrium, increased with time during the first 45 min and then remained unchanged toward the equilibrium adsorption. The maximum amounts of heavy metal ions adsorbed were 43.60+/-1.74, 68.81+/-2.75 and 48.22+/-1.92 mg/g for Cd(II), Pb(II) and Hg(II), respectively. The heavy metal ion adsorption on the pHEMA/chitosan membranes (carrying no dye) were relatively low, 6.31+/-0.13 mg/g for Cd(II), 18.73+/-0.37 mg/g for Pb(II) and 18.82+/-0.38 mg/g for Hg(II). Competitive adsorption of the metal ions was also studied. When the metal ions competed with each other, the adsorbed amounts were 12.74+/-0.38 mg Cd(II)/g, 28.80+/-0.86 mg Pb(II)/g and 18.41+/-0.54 mg Hg(II)/g. Procion Green H-4G immobilized poly(hydroxyethylmethacrylate/chitosan) membranes can be regenerated by washing with a solution of nitric acid (0.01 M). The percent desorption achieved was as high as 95%. These novel membranes are suitable for repeated use for more than five adsorption/desorption cycles without any considerable loss in adsorption capacity. Adsorption equilibria were well described by Langmuir equation. It can be concluded that Procion Green H-4G immobilized poly(hydroxyethylmethacrylate/chitosan) membranes may effectively be used for the removal of Cd(II), Pb(II) and Hg(II) ions from aqueous solutions.

Effects of acute exercise on the levels of iron, magnesium, and uric acid in liver and spleen tissues.

In this study, we investigated the effects of acute exercise on tissue levels of iron, magnesium, and uric acid of rats. Twenty adult Wistar albino rats were used for the study. They were divided into two groups: controls (n=10) and the study group (n=10). The study group was left into a small water pool and allowed to do swimming exercise for 30 min while controls rested. All of the animals were sacrificed, and their livers and spleens removed and homogenized immediately. The iron, magnesium, and uric acid levels of the homogenates were measured by an autoanalyzer (ILAB 900, Italy) with commercial kits from the same company. Results were evaluated by the Mann-Whitney U-test. According to our results, the liver iron levels increased significantly with exercise, whereas spleen iron levels decreased significantly (p<0.05) compared to controls. We found no significant differences in the levels of the other two parameters with exercise. These results show that the iron distribution in organs changes with exercise.

Occurrence of anthrax in Kars district, Turkey.

The aims of the study were to determine the prevalence of anthrax by bacteriologic methods in cattle and sheep between January 2000 and September 2001 and to determine the distribution of this zoonotic disease in humans in Kars district, Turkey. Bacillus anthracis was isolated and identified in 34 out of 38 (91%) cattle and 11 out of 17 (64%) sheep samples obtained from organs suspected of anthrax. The records of the Governmental Health Branch showed that 89 cases of cutaneous anthrax were diagnosed in humans during the study periods in the same district.

Effect of exercise on lipid peroxidation.

PURPOSE: The effect of physical exercise on lipid peroxidation was investigated. METHOD: 27 healthy young adult male subjects were included in this study. Urine samples were collected before and after exercises. Urinary malondialdehyde and creatinine levels (Cr) were measured. RESULTS: Urinary malondialdehyde levels were increased by exercise. While pre-exercise malondialdehyde levels were 5.02 +/- 1.26 nmol/mg Cr, post-exercise levels were 6.13 +/- 1.84 nmol/mg Cr (p < 0.05). CONCLUSION: These findings indicated that physical exercise induced lipid peroxidation.

Bilateral retinal vasculitis in a patient with lichen planus / Vasculite retiniana bilateral em um paciente com líquen plano

ABSTRACT Lichen planus (LP) is an autoimmune, inflammatory disease of unknown etiology that commonly affects the skin and mucous membranes. Retinal vasculitis is a group of vision-threatening disorders, in which autoimmunity is thought to play a role in pathogenesis. We present the case of a patient who was diagnosed with retinal vasculitis and who was followed up for mucosal LP. LP has not been reported as a cause of retinal vasculitis in the literature. We believe that the retinal vasculitis in this case was related to LP because cellular immunity plays a role in the pathogenesis of both entities.

RESUMO Líquen plano (LP) é uma doença auto-imune, inflamatória de etiologia desconhecida que normalmente afeta a pele e membranas mucosas. Vasculite retiniana engloba um grupo de doenças que ameaçam a visão em que a autoimunidade parece desempenhar um papel na sua patogênese. Apresentamos um caso que foi diagnosticado com vasculite da retina e que tinha sido acompanhado com LP de mucosa. LP não consta entre as causas de vasculite retiniana na literatura. Acreditamos que a vasculite da retina no nosso caso, foi relacionado com o LP considerando que a imunidade celular desempenha um papel na patogênese de ambas as entidades.