COVID-19 induced telogen effluvium.

COVID-19 is a febrile, infectious illness that has previously been associated with telogen effluvium (TE). However, to date, no study has been conducted to determine the incidence of TE in those who have had COVID-19. To assess the frequency of TE in post-COVID-19 patients and the correlation between the development of TE and the severity of COVID-19, to understand whether emotional stress or medications are responsible for the development of TE. Totally 204 patients with a history of SARS-CoV-2 infection in the last 3 months were included in the study. The diagnosis of TE was made by history of excessive hair shedding, hair pull test, diffuse or bitemporal thinning, and absence of anisotrichosis in trichoscopy. Patients who did not have any TE cause other than COVID-19 and whose hair loss started after COVID-19 were considered as "COVID-19 associated TE (CATE)." We found TE in 75 (36.7%) cases and androgenetic alopecia (AGA) in 85 (41.7%) cases. CATE was present in 27.9% of cases and developed on average 53.76 (± 23.772) days after COVID-19 real-time reverse transcription polymerase chain reaction (RT-PCR) positivity. The proportion of patients with CATE was numerically higher in hospitalized patients compared to outpatients (31.7% vs. 24.3%; p = 0.238); and significantly higher in women compared to men (42.3% vs. 6.2%; p < 0.001), in patients with hypertension compared to those without hypertension (40.4% vs. 23.1%; p = 0.014), and in patients who had respiratory symptoms compared to those who had not (31.7% vs. 14.0%; p = 0.021). The patients with and without CATE were similar in terms of stress level and usage of COVID-19 medications. Patients with AGA had a higher rate of hospitalization (69.4% vs. 35.3%; p < 0.001) and a higher incidence of fever (69.4% vs. 54.6%; p = 0.033) during COVID-19, compared to those without. TE developed in approximately one-quarter of people who have had COVID-19, and our study is the first to detect it. The time to onset of CATE, which was 7-8 weeks after the SARS-CoV-2 RT-PCR positivity, was not much different from post-infectious TE. Patients with severe COVID-19 seem to be more prone to develop TE. The presence of AGA is associated with a more severe COVID-19. During the pandemic, clinicians should consider a previous SARS-CoV-2 infection in patients presenting with hair loss.

[Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA external quality assessment national program results]. / MOTAKK HBV DNA ve HCV RNA dis kalite kontrol ulusal programi 2015-2016 sonuçlarinin degerlendirilmesi.

MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load . The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports without problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.

Leg Ulcers in a Patient With Systemic Lupus Erythematosus and Successful Treatment With Anticoagulant Therapy.

Among specific skin manifestations of systemic lupus erythematosus such as leukocytoclastic vasculitis, and vasculopathy, the development of leg ulcers is rare and frequently seen in patients with antiphospholipid antibody positivity. Here we report the rapid healing of a leg ulcer without antiphospholipid antibody positivity in a patient with lupus in response to anticoagulant therapy. As in our case, when immunosuppressive agents are inadequate in lupus patients who develop leg ulcers, it may be beneficial to support the treatment with anticoagulants.

In-depth exploration of challenges faced by women in the Turkish maritime industry: A qualitative study.

BACKGROUND: Women are underrepresented in the maritime industry compared to men. This sector continues to perpetuate gender discrimination and stereotypes, often overlooking women's physical competence. OBJECTIVE: To explore the multi-faceted challenges faced by Turkish female officers, unveiling the different dimensions of these challenges, and providing a comprehensive understanding of their experiences. METHODS: In-depth semi-structured interviews were conducted with 40 Turkish female officers actively working on seagoing vessels. The data were analyzed using MAXQDA software. RESULTS: The challenges faced by female officers were examined using content analysis. A total of 50 different codes were identified within 10 categories. The categories are gender inequality, violence, restriction of freedom, work-family conflict, mental health, physical differences, unsafe living space, insufficient communication with management, lack of psychometric testing and limited access to health services. CONCLUSION: By shedding light on the unique obstacles faced by female officers in Turkey, this study enhances our understanding of the underlying challenges and lays the groundwork for the implementation of effective policies and practices that promote the empowerment of women in the maritime industry.

Giant sacral schwannomas.

Sacral schwannomas are very rare tumors. There are merely around 50 cases reported in the literature most of which are case presentations. In this study we present a 13-case series, which is one of the most extensive series in the literature. Thirteen giant sacral schwannoma cases operated at Ege University, Faculty of Medicine, Neurosurgery Department between 1995 and 2010 are investigated retrospectively. All patients were assessed with direct radiography, computerized tomography (CT) and magnetic resonance imaging (MRI). The patients were operated, after the diagnosis through biopsy patients with Sridhar Type V classification are included in the study. Five patients were male, eight were female and the average age was 37.1 (ranging between 14 and 55). All the patients were suffering from back and leg pain at the time of consultation. Four patients had sphincter problems and three had weakness in the leg. After the biopsy and histological analysis, intralesionary resections were performed. Five patients went through both anterior and posterior interventions, six patients had only posterior and two had just anterior intervention. One patient had iliac vein injury during the anterior surgery. This patient was reoperated for embolectomy and vein graft because of thrombosis. Average follow-up period was 8.1 years (1-15 years). All patients were assessed with MR annually. A small residual tumor was detected in two patients, however they were not reoperated. Although sacral schwannomas are rare tumors, the diagnosis is not so difficult with CT and MRI. In this study, we suggest biopsy for predetermination of the nature of the tumor as it affects the treatment choice and the method of operation. Surgically, a simple intralesionary excision is an appropriate choice.

A quantitative study on the mental health of Turkish seafarers.

Physically and mentally healthy seafarers with professional knowledge and skills are needed for maritime transportation to be safe and sustainable. Mental problems experienced by seafarers can lead to negative consequences, such as bullying, substance dependency, assault, murder and suicide. Accordingly, this study examined the effects of differences between the socio-demographic characteristics of Turkish seafarers on their depression, which is an important criterion for determining mental disorders. Data collected from 403 participants through quantitative research methods were analyzed using SPSS version 25.0 and AMOS version 23.0. Although periodic physical and mental health checks are performed on seafarers, it was found from the analysis results that 33.2% of Turkish seafarers experience mental issues. Moreover, the study determined that the socio-demographic characteristics of seafarers made some differences in their depression levels.

Investigation of empty container shortage based on SWARA-ARAS methods in the COVID-19 era.

A shortage of empty containers has become a global crisis with more devastating effects than during previous periods when combined with various problems arising from the COVID-19, such as an increase in an imbalance of global trade between supply and demand, a decrease in the workforce, and restrictions by countries or regional quarantine practices. The absence of empty containers in regions where they are needed slows down industrial activities and locks the global supply networks, necessitating the use of alternative methods that are inefficient. Although this shortage causes many disruptions in global trade, solutions to the issue have not been studied in detail. Therefore, the aim of this study was to determine the issues caused by the shortage of empty containers and to rank the appropriate solutions. Four main criteria and sixteen subcategories used to define the issues, as well as a multi criteria decision model comprising five criteria for the solutions, were proposed based on information from the literature, sectorial publications, and expert opinions. The issues' weighted order of importance in our proposed model was calculated using the SWARA (Step-wise Weight Assessment Ratio Analysis) method; solutions were ranked using the ARAS (Additive Ratio Assessment) method. The results of the study revealed that the issues were ranked in importance as cost increases, uncertainty in the supply chain, volume loss, and increases in blank sailing announcements. Appropriate solutions were ranked as booking guarantee applications and information communication technologies, using shipper-owned containers, inducement calls, and E2E (end to end) delivery services.

Evaluation of the results of MOTAKK hepatitis C virus RNA genotyping and hepatitis delta virus external quality assessment programs during 2015-2016.

BACKGROUND/AIMS: To evaluate the HCV RNA genotyping and HDV RNA tests that are performed in molecular microbiology laboratories in Turkey as part of a national external quality assessment programme, MOTAKK (Moleküler Tanida Kalite Kontrol) (English translation: Quality control in molecular diagnostics). MATERIALS AND METHODS: Plasmas having different HCV RNA genotypes were used to prepare HCV genotype control sera. The HDV RNA main stock was prepared from patients with chronic delta hepatitis who had a significant amount of viral load detected, as per the WHO reference materials on viral load studies that were compiled for the purpose of developing HDV RNA control sera. Samples with different viral loads were prepared from this main stock by dilution. The prepared controls were delivered to the registered laboratories. The laboratories carried out the relevant tests and entered their results via the MOTAKK web page. External quality assessment (EQA) reports of the participants were uploaded to the website as well. RESULTS: In total, there were 23 participating laboratories, out of which 20 exclusively performed HCV genotyping, and 15 and 16 only performed HDV RNA in 2015 and 2016, respectively. The success rate of the results of the HCV genotype was 56-96% in 2015 and 30-95% in 2016. The tube with a 30% success rate had a recombinant type of HCV, therefore, it could not be detected in most of the laboratories. The HDV RNA results were evaluated qualitatively. Accordingly, HDV RNA detection rates of participant laboratories were 71-100% in 2015 and 50-100% in 2016. CONCLUSION: This study was the first national external quality control program in Turkey regarding HCV RNA genotyping and HDV RNA in the field of molecular microbiology, and it was implemented successfully.

[Investigation of siderophore, total matrix protease and elastase activity in Pseudomonas aeruginosa isolates from lower respiratory tract and extra-respiratory tract samples]. / Alt solunum yolu örnekleri ve solunum yolu disi örneklerden izole edilen Pseudomonas aeruginosa suslarinda siderofor, total matriks proteaz ve elastaz aktivitesinin arastirilmasi.

Pseudomonas aeruginosa is an important opportunistic pathogen. P. aeruginosa strains secrete several virulence factors, in the form of extracellular proteins. Adhesins, pyocyanin, proteases, hemolysins, exotoxin A and exoenzyme S are some of the virulence factors found in P. aeruginosa strains. In this study, the presence of siderophore, total matrix protease and elastase activities were investigated in a total of 157 P. aeruginosa strains isolated from lower respiratory tract (n: 81; sputum, bronchoalveolar lavage, tracheal aspirate) and extrarespiratory sites (n: 76; urine, wound, blood) of hospitalized pati ents. Chrome azurol S (CAS) agar plates were used for detection of siderophore activity. Hide powder azure was used for the investigation of total matrix protease activity and elastin congo red was used to test elastase activity. All strains gave positive reaction on CAS agar. Enzyme activities of the test strains were compared with the activity of P. aeruginosa PAO1 positive control strain. Mean total matrix protease and elastase activities were less than P. aeruginosa PAO1 activity in the test strains, however, some strains exhibited activity higher than PAO1. There was no significant difference for mean protease and elastase activities between the strains isolated from lower respiratory tract samples and the others (p > 0.05) [corrected] as well as no difference with respect to antibiotic resistance (p > 0.05) [corrected] It was found that ceftazidime and cefoperazone were the most resistant agents in both groups (67.9% and 57.9% for ceftazidime and 49.3% and 48.7% for cefoperazone, respectively). It was concluded that further in vivo studies are necessary to clarify the role of virulence factors of P. aeruginosa in the establishment of infection in different body sites.

[Investigation of serum resistance for Pseudomonas aeruginosa and Acinetobacter baumannii strains]. / Pseudomonas aeruginosa ve Acinetobacter baumannii suslarinda serum direncinin arastirilmasi.

Serum resistance is one of the major virulence factors of Gram negative bacteria. The aim of this study was to investigate the serum resistance of Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from various clinical samples (19 tracheal aspirates, 14 urine, 7 sputum, 7 wound and one peritoneal fluid specimens). Forty-eight P. aeuginosa and 48 A. baumannii strains were tested for human serum bactericidal effect by using Benge's method. Thirty-five (72.9%), 9 (18.7%), and 4 (8.3%) of P. aeruginosa strains were found to be resistant, intermediate sensitive and sensitive to serum, respectively. These rates were detected as 81.2% (39/48), 14.5% (7/48), and 4.1% (2/48) for A. baumannii strains, respectively. It can be concluded that, high serum resistance rates of P. aeruginosa and A. baumannii isolates might have an important role in the pathogenesis of infections of these bacteria.

Anticandidal activity of Pseudomonas aeruginosa strains isolated from clinical specimens.

Pseudomonads represent the major group of non-differentiating microorganisms that produce antibiotics. The antibiotic substances produced by this group of organisms are pyocyanin, pyrolnitrin and pseudomonic acid. This study was designed to investigate the in vivo and in vitro anticandidal activity of Pseudomonas aeruginosa strains against Candida species. Forty-four P. aeruginosa strains isolated from various specimens of intensive care patients were included in the study. All P. aeruginosa strains have pyocyanin pigment. Candida albicans ATCC 10231, Candida parapsilosis ATCC 22019, Candida krusei ATCC 6258 and a clinical isolate of Candida tropicalis were used to measure the anticandidal activity of Pseudomonas strains by Kerr's method. The total inhibition rates obtained by using blood agar of C. albicans, C. parapsilosis, C. krusei and C. tropicalis were 41%, 34%, 34% and 25% respectively. When Sabouraud dextrose agar (SDA) was used, the rates were detected as 45%, 39%, 48% and 25% respectively. In the mouse model of concomitant subcutaneous infection with Candida species and P. aeruginosa no yeast were recovered from skin cultures despite 100% detection of P. aeruginosa. Pseudomonas aeruginosa strains isolated from intensive care patients showed anticandidal activity against the Candida species in the present study and this point may be important in the following and treatment of patients.

Liver lipid peroxidation in experimental Escherichia coli peritonitis: the role of myeloperoxidase and nitric oxide inhibition.

BACKGROUND: The pathogenic mechanism of peritonitis is complex. The role of nitric oxide (NO) and myeloperoxidase (MPO) in liver lipid peroxidation accompanying bacterial peritonitis was evaluated. MATERIAL/METHODS: Peritonitis was induced by 0.2-ml intraperitoneal application of 10(5) (low E. coli) or 2 x 10(8) CFU/ml (high E. coli) E. coli isolated from a bacteriemic patient. A nonspecific nitric oxide synthase inhibitor, L-N(G)-nitroarginine methyl ester (L-NAME, 8 mg/kg i.p.) was given to determine the potential involvement of nitric oxide. Female mice were divided into five groups: controls, low E. coli, low E. coli + L-NAME, high E. coli, and high E. coli + L-NAME. After 24 hours, peritoneal lavage fluids and hepatic tissue samples were obtained for microbiological and biochemical evaluation. Hepatic tissue malondialdehyde (MDA) levels were measured to determine the free radical-induced lipid peroxidation in peritonitis. RESULTS: MDA levels were increased in the high, but not in the low, E. coli group (p0.001) compared with the controls. MDA levels were lower in the high E. coli + L-NAME group than in the high E. coli group, but still higher than in the control group (p0.01). Liver myeloperoxidase (MPO) activities were increased in the high E. coli group (p0.01), but not in the low E. coli group. L-NAME increased myeloperoxidase activities in both groups. CONCLUSIONS: These results are consistent with the notion that NO and MPO contribute in liver tissue lipid peroxidation in peritonitis. NO may have different effects in hepatic damage depending on the severity of infection.