Role of transforming growth factor-beta 1 and connective tissue growth factor levels in coronavirus disease-2019-related lung Injury: a prospective, observational, cohort study

ABSTRACT Background: Coronavirus disease-2019 (COVID-19) results in acute lung injury. This study examined the usefulness of serum transforming growth factor-beta 1 (TGF-β1) and connective tissue growth factor (CTGF) levels in predicting disease severity in COVID-19 patients with pulmonary involvement. Methods: Fifty patients with confirmed COVID-19 and pulmonary involvement between September 2020, and February 2021 (Group 1) and 45 healthy controls (Group 2) were classified into three subgroups based on clinical severity: moderate, severe, and critical pneumonia. Serum TGF-β1 and CTGF concentrations were measured on days 1 and 7 of admission in Group 1 using an enzyme-linked immunosorbent assay. These concentrations were also measured in control cases. The mean serum TGF-β1 and CTGF levels were then compared among COVID-19 patients, based on clinical severity. Results: Significantly higher mean serum TGF-β1 and CTGF levels were observed on both days in Group 1 than in the control group. The mean serum TGF-β1 and CTGF levels on day 7 were also significantly higher than those on day 1 in Group 1. The critical patient group had the highest serum TGF-β1 and CTGF levels on both days, and the difference between this group and the moderate and severe pneumonia groups was significant. Cutoff values of 5.36 ng/mL for TGF-β1 and 626.2 pg/mL for CTGF emerged as predictors of COVID-19 with pulmonary involvement in receiver-operating characteristic curve analysis. Conclusions: TGF-β1 and CTGF are potential markers that can distinguish COVID-19 patients with pulmonary involvement and indicate disease severity. These findings may be useful for initiating treatment for early-stage COVID-19.

The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study.

Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 ± 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.

The role of angiopoietin-2 and surfactant protein-D levels in SARS-CoV-2-related lung injury: A prospective, observational, cohort study.

INTRODUCTION: Coronavirus disease-2019 (COVID-19) is a respiratory disease whose clinical manifestation ranges from asymptomatic to severe respiratory failure. The purpose of this study was to investigate the place of serum surfactant-D (SP-D) and angiopoetin-2 (Ang-2) levels in predicting severity of disease in patients diagnosed with COVID-19. METHODS: Sixty-four patients diagnosed with COVID-19 between September 2020 and February 2021, 50 patients diagnosed with community-acquired pneumonia and a 50-member healthy control group were included in the study. Plasma samples and clinical data were collected within 72 h after admission, during hospital stay. Serum SP-D and Ang-2 concentrations were measured using the enzyme-linked immunosorbent assay. RESULTS: SP-D and Ang-2 levels were significantly higher in the mild-moderate pneumonia and severe/critical patient groups compared to the asymptomatic and noncomplicated COVID-19 patients (p < 0.001 for all groups). Serum SP-D and Ang-2 levels of severe-critical COVID-19 patients were significantly higher than CAP patients (p < 0.001). Powerful correlation was present between clinical severity of COVID-19 and SP-D and Ang-2 levels (r = 0.885 p < 0.001 and r = 0.913 p < 0.001, respectively). Cut-off values of 37.7 ng/ml (AUC = 0.763, p < 0.001, 95% confidence interval [CI] = 0.667-0.860) for SP-D and 4208.3 pg/ml (AUC = 0.659, p = 0.004, 95% CI = 0.554-0.763) for Ang-2 were identified as predictors of COVID-19 disease at receiver operating characteristic curve analysis. CONCLUSION: SP-D and Ang-2 are predictive factors in differentiating COVID-19 patients and determining severity of disease. These data may be important for the initiation of treatment in the early stage of the disease in patients with COVID-19.

Managing adult patients with infectious diseases in emergency departments: international ID-IRI study.

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

The Effect of the Presence of Lower Urinary System Symptoms on the Prognosis of COVID-19: Preliminary Results of a Prospective Study.

PURPOSE: To investigate the effectiveness of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS), which occur as a natural result of aging and androgen exposure, in predicting disease prognosis in male patients diagnosed with COVID-19. METHODS: The study was planned prospectively. The study included 63 male patients over 40 years of age diagnosed with COVID-19. The patients were diagnosed with COVID-19 based on the results of reverse transcription polymerase chain reaction tests of oropharyngeal and nasopharyngeal swabs obtained as per the World Health Organization guidelines. The presence of LUTS was assessed by the International Prostate Symptom Score (I-PSS), a subjective assessment, and the I-PSS was filled for the patients included in the study. The patients were divided into three groups based on their scores in the I-PSS survey: group 1: mild (0-7), group 2: moderate (8-19), and group 3: severe (20-35). The data of all three groups were statistically analyzed. RESULTS: In the assessment performed between the groups, it was identified that for patients in group 3, the length of hospital stay was longer, intensive care requirement was more frequent, and their mortality rates were numerically higher. In the evaluation made regarding the time to intensive care admittance, this was identified to be the shortest in group 3. CONCLUSION: As a result of our study, we think that in patients with COVID-19, BPH-related LUTS can guide clinicians in predicting prognosis.

Seroprevalence of hepatitis B, hepatitis C, and HIV in pregnant women from Eastern Turkey.

BACKGROUND/AIMS: The vertical transmission of hepatitis B virus, hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections are essential public health problems. In this study, we aimed to investigate the seroprevalence of the aforementioned infections among pregnant women. MATERIALS AND METHODS: This study was done retrospectively on pregnant women who presented for antenatal follow-up and delivery between 2013 and 2016. Data were collected from the hospital's electronic health records and patient files. Blood samples were analyzed at the microbiology laboratory of the hospital. HBsAg, anti-HBs, anti-HCV, and anti-HIV titers were tested using the chemiluminescence enzyme immunoassay method (Architect, Abbott Laboratories, USA). RESULTS: HBsAg and anti-HBs levels were tested in 35,295 pregnant women aged 18-45 years. The HBsAg and anti-HBs levels were positive in 425 (1.2%) and 9583 (27.7%) patients, respectively. From 2013 to 2016, the HBV carrier rates have continuously decreased from 1.4% to 0.8%, whereas the anti-HBs positivity has increased from 25.4% to 30.2%. Anti-HCV was detected in 6 of the 9709 (0.06%) patients. All the 7113 pregnant women screened for HIV showed negative results. CONCLUSION: Hepatitis B carrier rates among pregnant women gradually decreased with a simultaneous increase in the immunity rates. HCV seroprevalence was low and HIV positivity was not encountered in the study population.

[Relation of cervical cancer with the results of human papillomavirus (HPV) screening carried out via hybrid capture 2 method on 52.000 women in Erzurum]. / Erzurum ilinde 52.000 kadinda hybrid capture 2 yöntemi kullanilarak yapilan insan papilloma virüs (HPV) tarama sonuçlarinin serviks kanseri ile iliskisi.

Cervical cancer is a common female cancer that could be diagnosed early with screening methods. Almost all cases are caused by human papilloma virus (HPV) infection. Therefore, detecting the presence of HPV DNA is important for early diagnosis and treatment. Regular determination of screening tests enables early detection of patients with the risk of cervical cancer. For this purpose, since August 2014 a new screening program has been carried out by Early Diagnosis, Screening and Training of Cancer Centers (KETEM). The aims of our study were to detect the HPV prevalence in Erzurum and determine the major HPV types under the scope of population based cervical cancer screening program. Female patients between the ages of 30-65 were included in the study. Pap-smear and HPV DNA samples were taken simultaneously. The samples were examined in a national central laboratory. The study was performed using conventional methods in pap-smear samples. Pap-smear samples from HPV (-) patients were not included in the pathological evaluation. Pathological results of the pap-smear samples, which were taken from the HPV (+) cases, were sent to KETEM by national central laboratory and then these results were used. Within the scope of this study, 52.000 women were screened. Among all these women 2.4% of the cases were HPV DNA positive. HPV DNA samples were screened by Hybrid capture 2 (Qiagen, Germany) method. The highest positivity was observed at age 40 with 65 cases (5.1%) and the lowest positivity was observed at age 65 with 2 cases (0.1%). 60.1% of the HPV positive cases were at 30-45 age group, 35.2% were at 45-60 age group and 4.6% were at 65 and above age group. The most common type was HPV 16 with the frequency of 12.2% and this was followed by HPV 31 with 7.4% and HPV 51 with 6.7%,HPV 52 with 4.4% and HPV 68 with 4.3% frequencies. The rate of the HPV 18, which is the type of HPV that carries high risk for causing cervical cancer, was 3.0%. 49.2% of the HPV positive cases had single and 50.8% of them contained more than one type of HPV. The most common pathological appearance was "low grade cervical intraepithelial lesion" (LGSIL) detected in 115 cases (9.2%) and "atypical squamous cells of unknown significance" (ASC-US) detected in 93 cases (7.4%). Cases that had abnormal cytology were referred to colposcopy. Consequently, it was concluded that regional screening is important in terms of the determination of the HPV type for the early diagnosis of cervical cancer and vaccination so prevalence studies should be increased and supported.