Validation of a severity grading score (SGS) system for predicting the course of disease and mortality in patients with Crimean-Congo hemorrhagic fever (CCHF).

We aimed to validate a severity grading score (SGS) system for predicting the course of disease and fatality in Crimean-Congo hemorrhagic fever (CCHF). This SGS was established using several variables that were assumed to be associated with mortality and had clinical importance. We included patients diagnosed with CCHF from different centers. Patients who had symptoms of CCHF for <5 days were included. The patients were grouped into three categories according to mortality risk. An SGS ≤4 showed no association with mortality [n = 323 (79.9 % of the total study population), and all survived]. An SGS between 5 and 8 points was classified into the intermediate risk group (20 %), and 14 of 70 patients in this group died. An SGS ≥9 was classified as the high risk of mortality group and 11 of 11 patients in this group died (p = 0.001). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for an SGS >9 points at admission were 96, 100, 97, 100, and 44 %, respectively. This SGS system may help appropriate the triage of patients, decrease the cost of treatment, and improve the functionality of healthcare staff. The present study is the first investigation about the validation of an SGS system in patients with CCHF.

Acute Brucellosis Following Accidental Exposure to Brucella melitensis Rev 1 Vaccine.

Brucellosis is mainly transmitted to humans by direct contact with infected animals, consumption of non-pasteurized dairy products or through inhalation of aerosols. However, the disease may also be transmitted by exposure to Brucella vaccination that is used in veterinary medicine. In the literature, there were a few case reports of persons who developed brucellosis after unintentional inoculation or conjunctival exposure to the live Brucella vaccine. Here, we describe a sheep farmer with acute brucellosis that occurred as a result of unintentional percutaneous exposure to Brucella melitensis Rev 1 animal vaccine while vaccinating lambs.

Comparison of stress distribution around vertical and angled implants with finite-element analysis.

The distribution of stress around implants placed in the first molar region of the mandible was biomechanically analyzed in a two-dimensional mathematical model. Two types of implants, vertical and angled, were subjected to a vertical load of 100 N and a horizontal load of 50 N in turn. The magnitudes and contours of compressive and tensile stress within the surrounding bone were determined. For the sake of comparison, maximal compressive stress and maximal tensile stress at the surrounding bone were calculated. There were no measurable differences in stress values and contours when a horizontal load was applied to the vertical and angled implants. However, with the vertical loading, the compressive stress values were five times higher around the cervical region of the angled implant than around the same area in the vertical implant.

The effect of allopurinol on focal cerebral ischaemia: an experimental study in rabbits.

In this experimental study, the neuroprotective effect of the xanthine oxidase inhibitor allopurinol on focal cerebral ischaemia created by permanent middle cerebral artery occlusion (MCAO) was investigated. Using high performance liquid chromatography (HPLC), we measured hypoxanthine, xanthine, and uric acid (UA) levels in rabbit brains following focal cerebral ischaemia. Rabbits were randomly and blindly assigned into four groups of eight animals each. The control groups received 2% carboxymethylcellulose solution, while 10% allopurinol 150 mg/kg was given to the treatment group 1 h before ischaemia. Each group was subdivided into two groups which were sacrificed 4 h or 24 h after ischaemia, respectively. UA and xanthine values of the rabbits in the control groups were quite high at both times and highest after 24 h, particularly in the centre of the ischaemia. A significant decrease in UA and xanthine values was observed in rabbits that were given allopurinol (P<0.05). According to our results, it was concluded that allopurinol pretreatment protects neural tissue in the early period after arterial occlusion and prevents cerebral injury in the late period, especially in the perifocal area, possibly by preventing the formation of free radicals with xanthine oxidase inhibition.