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1.
Saudi Med J ; 44(8): 767-772, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37582565

RESUMO

OBJECTIVES: To investigate the usability of neopterin in demonstrating the progression of COVID-19. As a result of uncontrolled activation of COVID-19 monocytes and macrophages, IFN gamma increases and the resulting inflammatory response causes organ damage. IFN released from T cells causes an increase in gamma neopterin levels. Therefore, measurement of neopterin levels can be used to indicate immune system activation and disease progression. METHODS: The study was carried out prospectively in two different centers. The patients were divided into two groups (mild-moderate and severe) and clinical, laboratory, imaging findings and neopterin levels at hospitalization were compared. RESULTS: 100 patients were included in our study, 41 of these patients were male. Forty-six patients were identified as severe COVID-19. C-reactive protein, lymphocyte count, fibrinogen, D dimers, lactate dehydrogenase, procalcitonin, troponin and neopterin levels were significant in indicating disease severity. (p<0.05). In ROC analysis, 0.642 for neopterin, 0.698 C-reactive protein, 0.331 lymphocyte count, 0.679 procalcitonin, 0.633 fibrinogen, 0.667 D dimers, 0.655 troponin and 0.706 lactate dehydrogenase were detected and these values were significant. CONCLUSION: In our study, neopterin was detected as an important indicator in determining the course of COVID-19.


Assuntos
COVID-19 , Humanos , Masculino , Feminino , Neopterina , Proteína C-Reativa/metabolismo , Pró-Calcitonina , Fibrinogênio , Troponina , Lactato Desidrogenases , Biomarcadores
2.
Infect Dis Clin Microbiol ; 5(4): 267-280, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38633851

RESUMO

Hepatitis B virus (HBV) infection is the leading cause of chronic liver disease worldwide. HBV-infected patients are at a lifetime risk of developing liver cirrhosis and hepatocellular carcinoma (HCC). Today, pegylated interferon (Peg-IFN) and nucleos(t)ide analogs (NAs) are used in the treatment of patients with chronic hepatitis B (CHB). Both treatment options have limitations. Despite effective viral suppression, NAs have little effect on covalently closed circular DNA (cccDNA), the stable episomal form of the HBV genome in hepatocytes. Therefore, the cure rate with NAs is low, and long-term treatment is required. Although the cure rate is better with Peg-IFN, it is difficult to tolerate due to drug side effects. Therefore, new treatment options are needed in the treatment of HBV infection. We can group new treatments under two headings: those that interfere with the viral life cycle and spread and those that modulate the immune response. Clinical studies show that combinations of treatments that directly target the viral life cycle and treatments that regulate the host immune system will be among the important treatment strategies in the future. As new direct-acting antiviral (DAA) and immunomodulatory therapies continue to emerge and evolve, functional cures in HBV treatment may be an achievable goal.

3.
Infect Dis Clin Microbiol ; 4(4): 268-273, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38633716

RESUMO

Objective: Nosocomial infections (NIs) are major health problems with morbidity and mortality. Geriatric patients require intensive care unit (ICU) admission more frequently, and serious challenges occur during treatment. We aimed to evaluate the risk factors of NI and mortality in geriatric patients admitted to the ICU. Materials and Methods: The study was conducted between April 2018 and April 2019 in two hospitals. We prospectively recorded the data on the forms prepared according to daily ICU visits. Results: During the study period, 600 patients were hospitalized in the ICUs. Geriatric patients constituted 446 (74.3%) of the total number. The NI rate was 59% in adult patients and 80% in geriatric patients. The most frequent NI in geriatric patients was pneumonia (42%). Furthermore, the need for mechanical ventilation support, prolongation of hospital stay, total parenteral nutrition, and tracheostomy were statistically higher in geriatric patients with NI. The mortality rate in geriatric patients was statistically higher than in non-geriatric. We found the rates of prolonged hospitalization, NI development, malignancy, and cerebrovascular disease diagnosis significantly higher in geriatric patients than in non-geriatric patients. Conclusion: NI and mortality rate are higher in geriatrics than in adult patients. Pneumonia is the most common type of NI in the ICU. Identification of risk factors regarding NI and mortality in geriatric patients in ICU will contribute to developing strategies for prevention.

4.
Indian J Pathol Microbiol ; 62(1): 31-35, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30706856

RESUMO

CONTEXT: There is a correlation between prognosis of the colorectal carcinomas and the number of retrieved and metastatic lymph nodes (LNs) from mesentery/mesorectal region. At least 12 LNs must be sampled for accurate evaluation of patients. A number of factors related to surgeon, pathologist, patient and disease could affect the total LN number. For maximizing LN yield, pathologist can use ancillary methods, as fat clearance and special solutions. AIMS: This study investigates the effect of second evaluation after ethanol fixation on total and metastatic LN number and assesses factors that influence the dissected LN number. MATERIALS AND METHODS: 177 colorectal resections were refixed with ethanol for a night, after standard LN sampling. Mesentery/mesorectal tissue was reevaluated for missed LNs. Results were statistically analyzed, P values <0.05 were considered significant. RESULTS: Mean LN number increased from 26 to 30 (median: 20 to 25, P < 0.001) after ethanol fixation. Fourteen cases had additional metastatic LNs after reevaluation of the fat tissue and 5 of them upstaged. 22.5% (44/177) of the patients had <12 LNs before ethanol fixation and this decreased to 14.3% (26/177) after ethanol fixation. Resection type and length, tumor localization, size and histologic degree, pT and neoadjuvant therapy (P < 0.001) had an impact on the LN number (P = 0.034 for histologic degree, P = 0.02 for pT, P < 0.001 for others). CONCLUSIONS: Carrying out a second evaluation with ethanol fixation increased total and metastatic LN number and could lead upstage of pN. Ethanol fixation is cost-effective, easy accessible and applicable method; it may improve accuracy of LN assessment and staging, which are important for patients' outcome.


Assuntos
Neoplasias Colorretais/diagnóstico , Linfonodos/patologia , Metástase Linfática/diagnóstico , Mesentério/citologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Etanol , Feminino , Técnicas Histológicas , Humanos , Excisão de Linfonodo , Metástase Linfática/patologia , Masculino , Mesentério/patologia , Pessoa de Meia-Idade , Prognóstico
5.
J Diabetes Res ; 2018: 7104352, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29675434

RESUMO

AIMS: We aimed to evaluate the roles of interleukin-6 (IL-6), PCT, and fibrinogen levels in the differential diagnosis of the patients with infected diabetic foot ulcer (IDFU) and noninfected diabetic foot ulcer (NIDFU) and to compare those with C-reactive protein (CRP), white blood cell (WBC), and erythrocyte sedimentation rate (ESR). METHODS: Patients over 18 years with a diagnosis of type 2 diabetes mellitus and DFU who were followed up in our hospital between 1 January 2016 and 1 January 2017 were included in the study. In addition to this patient group, patients with diabetes but without DFU were determined as the control group. RESULTS: Thirty-eight patients with IDFU, 38 patients with NIDFU, and 43 patients as the control group were included in the study. Fifty-six point three percent of the patients who participated in the study were males, and the mean age was 61.07 ± 11.04 years. WBC, ESR, CRP, IL-6, and fibrinogen levels of the cases with IDFU were determined to be significantly higher compared to the cases in NIDFU (p < 0.01). The area under the ROC curve (AUROC) value was highest for CRP (0.998; p < 0.001), and the best cut-off value for CRP was 28 m/L. The best cut-off values for fibrinogen, IL-6, ESR, and WBC were 480 mg/dL, 105.8 pg/mL, 31 mm/h, and 11.6 (103 µ/L), respectively. CONCLUSION: Serum PCT levels were not found to be effective in the discrimination of IDFU and NIDFU. Serum IL-6 and fibrinogen levels seem to be two promising inflammatory markers in the discrimination of IDFU.


Assuntos
Infecções Bacterianas/diagnóstico , Calcitonina/sangue , Pé Diabético/diagnóstico , Fibrinogênio/metabolismo , Interleucina-6/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/sangue , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Pé Diabético/sangue , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Turk J Med Sci ; 46(5): 1323-1328, 2016 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-27966338

RESUMO

BACKGROUND/AIM: We aim to describe the clinical and laboratory characteristics, treatment, and outcomes of 21 patients with Brucella epididymo-orchitis (BEO) from Eskisehir Yunus Emre State Hospital, Turkey. MATERIALS AND METHODS: A total of 21 patients with BEO who were diagnosed and followed in the Infectious Diseases Clinic between June 2001 and June 2013 were evaluated retrospectively. RESULTS: One hundred and twenty-eight of 192 patients evaluated throughout the study were male and BEO was determined in 21 (16.4%) patients. A total of 18 (85.7%) patients had a titer of b1:160 in standard agglutination test (STA). Three patients with STA `160 were diagnosed by blood culture. When all the male patients were evaluated in terms of demographic, clinical, and laboratory findings, animal contact, rural living, and subacute clinical type were statistically significantly higher in the group that developed epididymo-orchitis. None of the patients underwent surgery after medical treatment, but due to a delay in diagnosis of brucellosis, orchiectomy was performed in 1 patient with the suspicion of tumor. CONCLUSION: In endemic countries like Turkey, BEO should be considered in the differential diagnosis of epididymo-orchitis. In uncomplicated patients, medical treatment is adequate for BEO.


Assuntos
Brucelose , Animais , Brucella , Epididimite , Humanos , Masculino , Orquite , Estudos Retrospectivos , Turquia
8.
Turk Patoloji Derg ; 29(3): 179-84, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24022307

RESUMO

OBJECTIVE: Cervical carcinoma has been included in the preventable diseases category ever since the use of cervical cytology in routine practice. The Pap test is an efficient screening test. We aimed to compare the cervical cytology diagnosis with biopsy and smear follow up results in our institution. MATERIAL AND METHOD: We aimed to compare the diagnosis of cytology material examined in our institution during the 2009-2012 period with their biopsy and smear follow ups. The diagnoses were compared with the follow up smears and/or cervical biopsies. RESULTS: 13610 Pap tests were examined during September 2009-July 2012. Among these cases, there were 370 atypical squamous cells of undetermined significance (ASCUS), 29 atypical squamous cells-high grade intraepithelial lesions cannot be excluded (ASC-H), 155 low grade squamous intraepithelial lesion (LSIL), 33 high grade squamous intraepithelial lesion (HSIL), and 5 atypical glandular cell (AGC) diagnoses. The ratio of atypical squamous cell (ASCUS and ASC-H) to squamous intraepithelial lesions was 2.12. Squamous intraepithelial lesion was verified in 47 of 91 ASCUS cases. Among patients who had a cervical biopsy, 52 of 64 LSIL cases and all of the 21 HSIL cases had biopsy-proven SIL. CONCLUSION: Atypical squamous cell (ASC) is the most common diagnosis in abnormal cervical cytology. As it is indefinite, ASC is used as a quality assurance parameter and the aim is to decrease its use. As the ratio of epithelial cell abnormality is variable in different populations, the ASC/SIL is a more definite variable to be used for quality assurance. The efficiency in clinical use of the cervical cytology screening test is determined by biopsy verification. Our epithelial cell abnormality, ASC/SIL ratio and cytology-histology correlation values were parallel to the literature, proving that the methods are used reliably at our institution.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Teste de Papanicolaou , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal , Adolescente , Adulto , Idoso , Biópsia , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
9.
Ann Diagn Pathol ; 17(1): 72-4, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23020998

RESUMO

Gastric xanthelasmas are uncommon benign lesions that are macroscopically well-demarcated yellow or yellow-white plaques and are microscopically formed by collections of foamy macrophages. Because gastric hyperplastic polyps may rarely be associated with xanthelasma, we aimed to report 5 cases of combined lesions showing features of gastric xanthelasma and hyperplastic polyps observed over the past 3 years at our institution among 4497 patients who underwent gastric endoscopy. The patients were 3 men and 2 women aged 45 to 78 years. The lesions were located in oxyntic mucosa, except one in the antrum, and measured 2 to 6 mm. Three patients showed associated chronic gastritis; none showed evidence of Helicobacter pylori infection. Combined lesions of hyperplastic polyp with xanthelasma appear to have an association with chronic gastritis, and the lipid accumulation may be the cause of hyperplasia in the overlying mucosa.


Assuntos
Gastrite/patologia , Pólipos/patologia , Gastropatias/patologia , Xantomatose/patologia , Idoso , Endoscopia Gastrointestinal , Feminino , Fundo Gástrico/patologia , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Antro Pilórico/patologia , Estômago/patologia
10.
Hepat Mon ; 12(10 HCC): e7492, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23162604

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) is the fifth most common fatal cancer and an important healthcare problem worldwide. There are many studies describing the prognostic and predictive effects of epidermal growth factor receptor 2 (c-erb-B2) and epidermal growth factor receptor 1 (EGFR), transmembrane tyrosine kinases that influence cell growth and proliferation in many tumors. OBJECTIVES: The current study aimed to investigate the expression levels of c-erb-B2, EGFR, PTEN, mTOR, PI3K, p27, and ERCC1 in hepatocellular carcinoma (HCC) and their correlation with other clinicopathologic features. PATIENTS AND METHODS: Fifty HCC cases were stained immunohistochemically with these markers. Correlations between the markers and clinicopathologic characteristics and survival rates were analyzed. RESULTS: No membranous c-erb-B2 staining was seen, whereas cytoplasmic positivity was present in 92% of HCC samples, membranous EGFR was observed in 40%, PI3K was found in all samples, and mTOR was seen in 30%, whereas reduced or absent PTEN expression was observed in 56% of samples and loss of p27 was seen in 92% of the cases. c-erb-B2 and mTOR overexpression, as well as reduced expression of p27, all correlated with multiple tumors (P = 0.041, P < 0.001, and P < 0.001, respectively). P27 loss, and mTOR and EGFR positivity were significantly correlated with AFP (P = 0.047, P = 0.004, and P = 0.008, respectively). Angiolymphatic invasion was more commonly seen in EGFR- and ERCC1-positive cases (P = 0.003 and P = 0.005). EGFR was also correlated with histological grade (P = 0.039). No significant correlations were found among PTEN , PI3K, and the clinicopathological parameters. Disease-free or overall survival rates showed significant differences among therapy modalities, AFP levels, angiolymphatic or lymph node invasions, and ERCC1 and p27 expression levels (P < 0.05). CONCLUSIONS: c-erb-B2, EGFR, mTOR, ERCC1 overexpression levels, and loss of p27 may play roles in hepatocarcinogenesis and may be significant predictors of aggressive tumor behavior. These markers were found to be correlated with certain clinicopathologic features, therapy modalities, and survival rates in the current study. These findings may help in planning new, targeted treatment strategies .

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