Association of SGLT-2 inhibitors with bacterial urinary tract infection in type 2 diabetes.

OBJECTIVE: We aimed to investigate the factors associated with UTI in patients with T2D whether being treated with SGLT-2i or not. METHODS: Adult patients with T2D, whose urine culture results were available, were analyzed retrospectively. Urine culture was obtained from mid-flow urine. Antibacterial treatment was given to the patients with UTI, which was defined by positive urine cultures and/or clinical findings. We grouped the patients as follows: Group A, those treated with SGLT-2i; and Group B, those not treated with SGLT-2i. RESULTS: A total of 101 patients were included. Median age was 56 (45-67), 56.4% (n = 57) of the patients were female. Urine culture was positive in 54.9% (n = 28) and 16% (n = 8) of Group A (n = 51) and Group B (n = 50), respectively. Of those for whom urine culture was positive, Escherichia coli was isolated in 83.3% (n = 30), and both Escherichia coli and Klebsiella pneumoniae (K.pneumoniae) were isolated in 16.7% (n = 6). Klebsiella pneumoniae was isolated only from Group A. The need for and duration of hospitalization were higher in Group A (p < 0.001). UTI was detected in 60 patients. ROC analysis showed that a HbA1c of > 5.8% was associated with UTI with good accuracy (AUC: 0.835, p < 0.001). In multiple logistic regression analysis, SGLT-2i use and glucosuria were positive predictors for UTI (p = 0.004, Odds Ratio: 1984.013; and p = 0.028, and Odds Ratio: 12.480, respectively). CONCLUSION: Besides the association of HbA1c and BMI with UTI, SGLT-2i use and glucosuria predicted UTI. Urine culture is important with respect to the choice of antibacterial treatment, especially in those patients under SGLT-2i treatment. The effect of SGLT-2i on the development of UTI is independent of baseline BMI score or HbA1c.

Could ischemia-modified albumin levels predict the severity of disease in SARS-CoV-2 infection?

INTRODUCTION: Ischemia-modified albumin (IMA) level increases in inflammatory conditions. We aimed to investigate the association between IMA levels and the severity of coronavirus disease 2019 (COVID-19) infection in adult patients. METHODOLOGY: We grouped adult patients with COVID-19 infection: Group A - mild symptoms, but normal computed tomography (CT), Group B - mild/moderate illness, and Group C - severe or critical illness. We measured IMA levels at the time of diagnosis of COVID-19 infection. RESULTS: Mean age of the total number of patients (n = 90) was 54.43 (± 8.11) year, and 46.7% (n = 42) were female. IMA levels were highest in Group C and lowest in A (p < 0.001). The most important factor predicting COVID-19 disease severity was IMA. Type 2 diabetes was more frequent in Group C (n = 31) than in Group B (n = 30) (p = 0.042). Asthma was less frequent, and coronary artery disease was more frequent in Group C than in Group A (n = 29) and B (p = 0.009). Duration of hospitalization was highest in Group C (p < 0.001). CONCLUSIONS: We analyzed a sample of patients with COVID-19 infection and found that IMA predicted severe COVID-19 disease. Disease severity grouping was based on patients' clinical and radiological features. IMA level measured when SARS-CoV-2 infection is diagnosed may be a useful marker in predicting likely disease severity or intensive care need.

The epidemic typhus and trench fever are risk for public health due to increased migration in southeast of Turkey.

Pediculus humanus capitis is a small ectoparasitic insect that has lived and feds on human beings for thousands of years. Molecular techniques have been used for Pediculus species identification and evolutionary, phylogenic, and ecological studies. A total of 23 adults of P. h. capitis were collected in Gaziantep, located in southeast Turkey, and DNA was isolated from all P. h. capitis using DNA extraction kit. All DNA samples were screened for investigate of Ricettsia prowazekii, Bartonella quintana and Borrelia recurrentis with real-time polymerase chain reaction. In addition, we investigated genetic variation in DNA samples of Pediculus humanus capitis using the cytochrome oxidase I genetic DNA sequence. We found 4 (17.4%) Ricettsia prowazekii and 3 (13.1%) Bartonella quintana in DNA samples of Pediculus humanus capitis, while we did not find any Bartonella recurrentis in any of the DNA samples. We demonstrated 1.8% genetic variations in DNA samples of Pediculus humanus capitis with Bartonella quintana. The phylogenetic tree based on the cytochrome oxidase I gene revealed that P. h. capitis in southeast Turkey are classified into two clades (clade A, clade B) and Bartonella quintana was found in only clade B. However, we did not find any genetic variations in other DNA samples in this region. The genetic variations may be related to P. h.capitis vector of Bartonella quintana has found in this study. In addition, this study was shown that P. h. capitis do transmit Rickettsia prowazekii and Bartonella quintana to people, epidemic typhus and trench fever may emergence in Gaziantep southeast of Turkey in the future.

Pediculosis capitis is a growing neglected infestation due to migration in southeast Turkey.

Demographic, socio-economical, and environmental changes affecting prevalence of Pediculosis capitis. The aim of this study was to investigate the prevalence of P. capitis and external factors affecting the distribution of P. capitis. A total of 6004 primary-school students between 5 and 11 years were screened for P. capitis at 28 different primary-schools in Gaziantep, located in southeastern of Turkey, during different two education terms (First education term is in September 2013 to May 2014, second education term is in September 2014 and May 2015). The prevalence of P. capitis was found to be positive 1.5 % (90/6004) and 6.9 % (415/6004) in first education term and in second education term, respectively. In this study shown that the rate of P. capitis's prevalence was increased 5.4 % in Gaziantep. P. capitis is a neglected infestation and it has re-emerged in Gaziantep, located in the southeastern of Turkey. Health staff member must improve health education programs in primary-school students especially girl students.

Levels of malondialdehyde, myeloperoxidase and nitrotyrosine in patients with chronic viral hepatitis B and C.

OBJECTIVES: Oxidative stress is one of the potential biochemical mechanisms involved in the pathogenesis of chronic viral hepatitis. The aim of the present study was to determine levels of oxidative stress in a large group of chronic viral hepatitis (CVH) patients who had not received antiviral treatment, and to assess the relationship between these parameters and viral load, fibrosis score and necro-inflammation of the liver. MATERIAL AND METHODS: Two hundred CVH patients and 107 healthy subjects were included in this study. Malondialdehyde, myeloperoxidase and nitrotyrosine levels were determined. RESULTS: Malondialdehyde levels were significantly higher in the CVH patients than in the control group (p < 0.05), whereas myeloperoxidase activities were significantly lower (p < 0.001). There was no statistically significant difference between nitrotyrosine levels of the patients and the controls (p > 0.05). Additionally, no significant correlation was shown between these markers and viral load, necro-inflammation and fibrosis of the liver in chronic viral hepatitis patients. CONCLUSIONS: The data from this study demonstrate that there is a disturbance in oxidative balance in patients with chronic viral hepatitis, but this imbalance was not correlated with viral load, necro-inflammatory activity or fibrosis of the liver.

Unusual presentation of neurobrucellosis: a solitary intracranial mass lesion mimicking a cerebral tumor : a case of encephalitis caused by Brucella melitensis.

Among the diverse presentations of neurobrucellosis, solitary intracranial mass lesions are extremely rare. To the best of our knowledge, we describe here the second case of neurobrucellosis mimicking a cerebral tumor caused by Brucella melitensis. The mass lesion was clinically and radiologically indistinguishable from a brain tumor. The diagnosis was established by isolating Brucella melitensis in a blood culture and a positive Wright's agglutination test on the cerebrospinal fluid at 1:320 titers. Paraffin sections of the cerebral mass showed nongranulomatous encephalitis. We suggest that patients with an isolated intraparenchymal mass lesion with nongranulomatous encephalitis should also be studied for brucellosis in endemic areas.