Investigation of hematologic findings related to brucellosis in Anatolian region.

OBJECTIVES: To investigate the prevalence of hematologic findings and the relationship between hemogram parameters and brucellosis stages in patients. METHODS: This multi-center study included patients older than 16 years of age who were followed up with a diagnosis of brucellosis. Patients' results, including white blood cell, hemoglobin, neutrophil, lymphocyte, monocyte, mean platelet volume, platelet and eosinophil counts were analyzed at the initial diagnosis. RESULTS: In this study 51.3% of the patients diagnosed with brucellosis were male. The age median was 45 years for female and 41 years for male. A total of 55.1% of the patients had acute brucellosis, 28.2% had subacute, 7.4% had chronic and 9% had relapse. The most common hematologic findings in brucellosis patients were anemia (25.9%), monocytosis (15.9%), eosinopenia (10.3%), and leukocytosis (7.1%). Pancytopenia occurred in 0.8% of patients and was more prominent in the acute phase. The acute brucellosis group had lower white blood cell, hemoglobin, neutrophil, eosinophil, and platelet counts and mean platelet volume, and higher monocyte counts compared to subacute and chronic subgroups. CONCLUSION: It was noteworthy that in addition to anemia and monocytosis, eosinopenia was third most prominent laboratory findings in the study. Pancytopenia and thrombocytopenia rates were low.

Molecular Characterization of Giardia intestinalis and Cryptosporidium spp. Detected in Humans in Agri, Türkiye.

Background: We aimed to determine the prevalence of Giardia intestinalis and Cryptosporidium spp. in patients who admitted hospital with diarrhea and to gain information about the transmission of these parasites in Agri, Türkiye. Methods: This study included 184 patients who applied to Agri-Diyadin State Hospital, Türkiye in 2022. The immunochromatographic card test was used for detection of the G. intestinalis and Cryptosporidium spp. Nested PCR-RFLP analysis of the COWP gene and sequence analysis of the gp60 gene were used to genotype and subtype Cryptosporidium spp., whereas Nested PCR and sequence analyses of ß-giardin gene were used genotype G. intestinalis. Results: Of the 184 stool specimens examined, 12 (14.29%) and 7 (3.80%) were positive for G. intestinalis and Cryptosporidium spp., respectively. The Cryptosporidium species were identified as C. parvum belonging to the IId sub-type family. The G. intestinalis were identified assemblages A. Conclusion: Assemblage A, which is associated with diarrhea, is responsible for giardiasis and C. parvum IId subtype, often found in sheep, goats and cattle, is responsible for cryptosporidiosis in Agri, Türkiye.

Prognostic Significance of NLR, LMR, PLR, and CRP-Albumin Ratio in Lower Extremity Cellulitis: A Hospitalization and Recurrence Analysis.

Cellulitis, an inflammatory disease of the skin and subcutaneous tissue caused by bacterial agents, frequently causes lower-extremity wounds. Many new biomarkers have been introduced to aid the diagnosis of inflammatory diseases. In this study, we aimed to evaluate the risk of recurrence of lower-extremity cellulitis wounds and the factors determining the need for hospitalization. Demographic characteristics and underlying diseases of the patients, white blood cell count, neutrophil, lymphocyte, monocyte, neutrophil, lymphocyte, lymphocyte and monocyte counts at admission, white blood cell count at admission, platelet count, total protein, albumin, erythrocyte sedimentation rate, C-reactive protein (CRP), procalcitonin level, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and CRP/albumin ratio were evaluated. Of the 132 patients with lower extremity cellulitis wounds, the median age was 56 years (range, 20-96 years), and 88 (66.7%) were male. Diabetes mellitus was the most commonly associated systemic disease. The most common symptom (97%) was a rash. Of the patients, 80 (60.6%) were hospitalized and 52 (39.4%) were treated as outpatients. Seventeen (12.9%) patients had recurrent cellulitis. While comorbidities and increased lesion size increased the risk in patients with recurrent cellulitis, median platelet count (P = .010), D-dimer level (P = .036), and CRP-Alb ratio (P = .019) were higher. Particularly increased lesion size, platelet count, total protein, and CRP levels should be a warning to clinicians in terms of the need for hospitalization and the risk of recurrence in patients with cellulite. In our study, PLR and CRP/albumin ratios were found to be high in these patient groups, and determining the usefulness of new biomarkers through new studies will give us a new perspective in clinical practice.

Understanding clinical outcomes and factors influencing mortality in intensive care unit patients with COVID-19-associated candidemia.

BACKGROUND: During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection. OBJECTIVES: The aim of this international study was to evaluate the clinical outcomes and identify factors influencing mortality in patients who developed candidemia during their COVID infection. PATIENTS/METHODS: This study included adult patients (18 years of age or older) admitted to the intensive care unit (ICU) and diagnosed with COVID-associated candidemia (CAC). The research was conducted through ID-IRI network and in collaboration with 34 medical centres across 18 countries retrospectively, spanning from the beginning of the COVID pandemic until December 2021. RESULTS: A total of 293 patients diagnosed with CAC were included. The median age of the patients was 67, and 63% of them were male. The most common Candida species detected was C. albicans. The crude 30-day mortality rate was recorded at 62.4%. The logistic regression analysis identified several factors significantly impacting mortality, including age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07, p < .0005), SOFA score (OR 1.307, 95% CI 1.17-1.45, p < .0005), invasive mechanical ventilation (OR 7.95, 95% CI 1.44-43.83, p < .017) and duration of mechanical ventilation (OR 0.98, 95% CI 0.96-0.99, p < .020). CONCLUSIONS: By recognising these prognostic factors, medical professionals can customise their treatment approaches to offer more targeted care, leading to improved patient outcomes and higher survival rates for individuals with COVID-associated candidemia.

Testicular involvement of Brucellosis: A 10-year, multicentre study.

INTRODUCTION: The genito-urinary system is one of the most common areas of involvement in brucellosis. To present the epidemiological, clinical, and laboratory characteristics of patients with testicular involvement associated with brucellosis, together with the diagnostic and therapeutic approaches. METHODOLOGY: Patients followed up for brucellosis-related testicular involvement between January 2012 and November 2022 were included in the study. Brucellosis is defined as the production of Brucella spp. in cultures, or clinical symptoms together with the serum standard tube agglutination test titer of ≥ 1/160. Inflammation in scrotal Doppler ultrasonography was based on testicular involvement. RESULTS: A retrospective evaluation was made of the data of 194 patients with brucellosis-related testicular involvement. The rate of determination of testicular involvement in brucellosis was 2.57%. The most affected patients were determined in the 16-30 years age range. On presentation, brucellosis was in the acute stage in 83.7% of patients. The most common symptoms on presentation were swelling and/or pain in the testes (86.6%). In the patients where a spermiogram could be performed, oligospermia was determined in 41.7%, and aspermia in 8.3%. When the testicular involvement of brucellosis was evaluated, epididymo-orchitis was present at the rate of 55.7%, epididymitis at 27.3%, and testis abscess at 5.1%. CONCLUSIONS: Although epididymo-orchitis was the most frequently determined form of involvement in this study, there was also seen to be a significant number of patients presenting with epididymitis. Male patients presented with the clinical status of brucellosis should be questioned about swelling and pain in the testes to avoid overlooking testicular involvement.

A Ruptured Cystic Echinococcosis in the Gallbladder and Intra/Extrahepatic Biliary Tract, Radiological and Surgical Imaging Findings.

Cystic echinococcosis is a common parasitic infestation that can still cause serious complications in endemic areas. Intrabiliary rupture is a well-defined complication, but rupture into the gallbladder is rare. The disease may present with cholecystitis and cholangitis. Clinicians and radiologists working in the emergency room will find the management of the disease much easier if they become familiar with the clinical and radiological findings of the cyst. In this article, a 28-year-old male admitted to the emergency department with acute abdominal pain who was examined for suspected acute cholecystitis and diagnosed with a rupture of the hydatid intra/extrahepatic bile ducts and gallbladder is presented. Our aim is to present the clinical findings and surgical images of the case (ultrasonography, computed tomography, magnetic resonance imaging) and compare them with the literature.

Investigation of Giardia spp., Cryptosporidium spp. and Cyclospora cayetanensis in Samples Collected from Different Spring Waters Igdir, Türkiye

OBJECTIVE: In this study, it was aimed to investigate the physical and chemical properties of different spring waters and parasitic factors with different methods. METHODS: This study was carried out on 69 water samples collected from different spring waters in and around Igdir Province in April and June 2021. The samples were analyzed by native-Lugol, modified acid-fast staining, and nested polymerase chain reaction (nPCR). In addition, altitude (meter) and pressure (mmHg) measurements were made at the point where the water samples were taken. RESULTS: One or more parasites were detected in 27.5% of the 69 water samples examined. Only C. cayetanensis was found in 13% of the samples, only Cryptosporidium spp. in 10.1%, only Giardia spp. in 1.4%, only C. cayetanensis and Giardia spp. in 1.4%, only C. cayetanensis, Cryptosporidium spp., and Giardia spp. in 1.4%. Only Giardia spp. cyst (4.3%) was detected by the direct examination method. While C. cayetanensis and Cryptosporidium spp. oocysts were detected in 8.7% and 7.2% of the samples by the modified acid-fast staining method, C. cayetanensis was detected in 15.9% and Cryptosporidium spp. was detected in 11.6% of the samples by nPCR. When the C. cayetanensis and Cryptosporidium spp. positivity rates were compared according to the characteristics of the water, there was no statistical difference between the altitude, salinity, pH, mmHg, and temperature (kelvin) values, but a significant correlation was found between the amount of dissolved oxygen and Cryptosporidium spp. positivity (p=0.047). CONCLUSION: Cryptosporidium spp., C. cayetanensis, and G. intestinalis are important waterborne pathogens that can cause epidemics. It is our belief that in order to reduce the risk of contamination of these parasitic factors with spring waters, public awareness should be raised, infrastructures should be improved, and new water treatment techniques, such as ultraviolet, ozonation and monitoring systems, should be used.

Monitoring spatio-temporal changes in wetlands with harmonized image series in Google Earth Engine.

Study of rapidly changing lakes and wetlands with remote sensing methods is critical for understanding the climatic and anthropogenic effects. However, most of the studies search for the change of water body in specific time periods. Although this approach reduces the workload related to downloading and processing a large number of satellite images in computer environment, it actually causes ignoring some critical changes that occurred out of specified time periods. On the other hand, this situation reduces the data volume and the limited data causes problems for the management of water resources.  The Google Earth Engine (GEE) platform allows the opportunity to rapidly and practically process large-scale temporal data without downloading. In this study, areal changes in Lake Aksehir in Türkiye, from 1985 to 2020, were calculated and mapped by the GEE as a case. In order to calculate the changes, the Landsat 5 TM, 7 ETM + and 8 OLI&TIRS images were harmonized and created annual mosaics. The Normalized difference water index (NDWI) and the automated water extraction index (AWEI) were applied to these annual mosaics. By this approach, the change in the water area representing a shrank by 87% on average (according to the calculations 91% for the NDWI and 83% for the AWEI) from 1985 to 2020 was assessed practically and rapidly on annual mosaics created from all images between the studied period, instead of assessment based on images taken on only one date in the chosen years as in previous studies. Such an approach will provide time and labour savings and provide more meaningful and uninterrupted data for studies about changes in other wetland areas.

Bibliometric Analysis of the Publications on Middle East Respiratory Syndrome Coronavirus Published Between 2012-2022.

Objective: This study aimed to conduct a bibliometric analysis of the global scientific output related to the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) between 2012 and 2022. Materials and Methods: The Web of Science database was searched for articles on MERS-CoV published between 2012 and 2022 for bibliometric analysis. The parameters such as publication year, publication type, funding agencies, research institutions, journals, impact factors, language, and citation numbers of articles were analyzed. Results: We included 1475 articles on MERS-CoV from 86 countries. The United States was the most published country on MERS-CoV, with 487 articles. The Saudi Ministry of Health (7.53%), King Saud bin Abdulaziz University for Health Sciences (6.92%), and The Egyptian Knowledge Bank (6.64%) were the most published institutions. The researchers who published the most on MERS-CoV were from Saudi Arabia. One thousand two hundred six funding agencies funded publications on MERS-CoV, most of which were funded by agencies from the United States. Conclusion: MERS-CoV remains important because no treatment and no vaccine have been found since it was first detected, and accordingly, it continues to affect the world with new outbreaks and high mortality rates. In addition, experiences with MERS-CoV during the coronavirus disease 2019 (COVID-19) pandemic have guided new research on COVID-19, so scientific interest in MERS-CoV is still ongoing.

Intrapartum and Postpartum Reactivation of Hepatitis B in Pregnant Patients: a multicentre study / Reactivación intraparto y posparto de la hepatitis B en pacientes embarazadas: un estudio multicéntrico

Introduction: Changes in the immune system during pregnancy have been associated with reactivation of the hepatitis B virus in women chronic hepatitis B infection not receiving antiviral therapy. The aim of this study is to examine the development of intrapartum and postpartum hepatitis B reactivation in pregnant patients not being treated for chronic hepatitis B.Material and Methods: Pregnant women diagnosed with chronic hepatitis B and not receiving treatment between 2017 and 2022 in five centres in the east and southeast Turkey included in this study. In order to evaluate biochemical and viral reactivation from intrapartum and postpartum periods, patients with data for at least two periods were included in the study.Results: Evaluations were made on 171 pregnant women diagnosed with chronic hepatitis B. Reactivation occurred in 43 (25.2%) patients, in the postpartum period in 14 (32.35%) and in the intrapartum period in 29 (67.44%). Reactivation occurred most often in the 3rd trimester (n: 13, 30.2%). A significant increase was observed in the alanine aminotransferase levels of the patients with reactivation in the first trimester compared to 6 months prepartum and in the second trimester compared to the first trimester (p=0.038, p=0.039, respectively). The prepartum HBV DNA level (cut-off point =192 IU/ml) of patients with HBeAg negativity was found to have diagnostic power for reactivation of 0.684 (95% CI: 0.575-0.792, p=0.002) with 65.9% sensitivity and 68.6% specificity. Viral reactivation was observed in the first trimester in one patient and hepatitis B surface antibody was seen in the postpartum period.Conclusions: Asymptomatic viral reactivation occurred at the high rate of 25.1% in this series. To be able to identify reactivation as early as possible, pregnant patients should be followed up closely in the intrapartum and postpartum periods. (AU)

Introducción: Los cambios en el sistema inmunológico durante el embarazo se han asociado con la reactivación del virus de la hepatitis B en mujeres con infección crónica por hepatitis B que no reciben terapia antiviral. El objetivo de este estudio es examinar el desarrollo de la reactivación de la hepatitis B intraparto y posparto en pacientes embarazadas que no reciben tratamiento para la hepatitis B crónica.Material y Métodos: Mujeres embarazadas diagnosticadas de hepatitis B crónica y que no recibieron tratamiento entre 2017 y 2022 en cinco centros del este y sureste de Turquía incluidos en este estudio. Para evaluar la reactivación bioquímica y viral de los períodos intraparto y posparto, se incluyeron en el estudio pacientes con datos de al menos dos períodos.Resultados: Se evaluaron 171 gestantes con diagnóstico de hepatitis B crónica. La reactivación ocurrió en 43 (25,2%) pacientes, en el puerperio en 14 (32,35%) y en el intraparto en 29 (67,44%). La reactivación ocurrió con mayor frecuencia en el tercer trimestre (n: 13, 30,2%). Se observó un aumento significativo en los niveles de alanina aminotransferasa de las pacientes con reactivación en el primer trimestre en comparación con los 6 meses preparto y en el segundo trimestre en comparación con el primer trimestre (p = 0,038, p = 0,039, respectivamente). Se encontró que el nivel de ADN del VHB antes del parto (punto de corte = 192 UI/ml) de pacientes con HBeAg negativo tenía un poder diagnóstico para la reactivación de 0,684 (IC del 95 %: 0,575-0,792, p = 0,002) con una sensibilidad del 65,9 % y una sensibilidad del 68,6 %. % especificidad. Se observó reactivación viral en el primer trimestre en una paciente y se observaron anticuerpos de superficie contra la hepatitis B en el período posparto.Conclusiones: La reactivación viral asintomática ocurrió en la alta tasa de 25,1% en esta serie. ... (AU)

Investigation of Pneumocystis jirovecii in Lung Cancer Patients with the Nested PCR Method

Objective: Pneumocystis jirovecii (P. jirovecii) is an opportunistic pathogen in humans. Early diagnosis and optimal treatment of patients with P. jirovecii pneumonia (PJP) remains a key priority. This study investigated P. jirovecii in patients with lung cancer using the nested-polymerase chain reaction (PCR) method and examined the relationship between P. jirovecii and clinical findings. Methods: The study included 60 patients with lung cancer and 30 patients without lung cancer. The bronchoalveolar lavage (BAL) fluid samples of these 90 individuals were taken for diagnostic purposes in the University of Health Sciences Turkey, Van Training and Research Hospital, Clinic of Chest Diseases. Patient information was recorded. After DNA isolation from the BAL fluid samples taken from patients, the nested-PCR protocol for amplification of mtLSUrRNA in P. jirovecii was performed. Results: P. jirovecii DNA was detected in 40 (66.67%) of the lung cancer patients included in the study and in six (20%) patients without lung cancer, that is, in 46 (51.11%) patients. The rate of nested-PCR positivity in the lung cancer group was significantly higher than that in the non-lung cancer group (p=0.0001). Additionally, a statistically significant correlation was found between anorexia and weight loss, fever and sputum P. jirovecii positivity in patients with lung cancer (p<0.005). Conclusion: These findings suggest that lung cancer patients should be evaluated for PJP.

Trends in Naegleria fowleri global research: A bibliometric analysis study.

Naegleria fowleri is one of the most dangerous protozoan agents. This article describes a bibliometric review of the literature on N. fowleri research indexed in WoS during a 51-year period. The VOSviewer visualization methodology was used to conduct a bibliometric study. The data included articles from the Web of Science database, nations, institutions, journals, keywords, co-authorship, co-citations, international collaborations, and citation rates. A total of 1106 articles were retrieved from the Web of Science database. The articles were cited 21,904 times in total (cited 12,138 times without self-citations). The average citation per article was 19.82. The Hirsch index was 63. The leading country according to the number of published articles was the United States of America (USA) (n = 447; 40.416%), followed by Mexico (n = 80; 7.233%), and Australia (n = 63; 5.696%). Other than these top three countries, the publications were from 74 countries globally. Especially after the 2000s, both the number of citations and the number of publications exhibited an increasing trend. The Virginia Commonwealth University (USA) (9.584%), Centers for Disease Control Prevention (USA) (8.770%), and Instituto Politecnico Nacional Mexico (4.069%) were the leading affiliations. Most of the leading affiliations were from the USA and Mexico. In conclusion, a bibliometric evaluation of N. fowleri was performed for the first time. Authors affiliated with institutions in the USA and Mexico have led scientific production on PAM. Efforts should be made to help developing countries with the highest prevalence of N. fowleri to develop scientific research networks with the USA and/or Mexico in order to increase research with interdisciplinary teams.

Investigation of Intestinal and Blood Parasites in People Returning to Turkey with a History of Traveling Abroad During the Pandemic

Objective: To investigate intestinal and blood parasites in people who have a history of traveling abroad during the Coronavirus disease-2019 pandemic and returning to Turkey. Methods: In this study, 104 patients with gastrointestinal system and/or fever complaints who had traveled abroad during the pandemic period and returned to Turkey were included. Parasitic agents were investigated by taking blood and stool samples from the patients. Additionally, urine samples were obtained from patients with hematuria or dysuria with the suspicion of schistosomiasis. A direct microscopic examination, the Crypto-Giardia immunochromatographic test, and ELISA methods were used in the examination of the stool samples. In order to detect Plasmodium species, blood samples were examined by preparing both the rapid diagnostic test and thick drop and thin smear preparations. Results: One or more parasite species were detected in 38 (38.5%) of 104 patients included in the study. While intestinal parasites were detected in 16 (32%) of 50 patients who traveled to Iran and 16 (33.3%) of 48 patients who traveled to Northern Iraq, blood parasites were not found. Schistosoma mansoni was detected in all 5 of the patients with a history of traveling to Sudan. Plasmodium falciparum was detected in 1 patient who traveled to the African continent. Conclusion: It is vital to take precautions to prevent parasitic diseases, such as malaria and schistosomiasis, during travels to African countries. During travels to neighboring countries of Turkey, such as Northern Iraq and Iran, hygiene should be paid attention to, so as to prevent contracting intestinal parasitic diseases. In addition, it was concluded that people who plan to travel abroad should have information about the endemic parasitic diseases of the country that they are going to.

Investigation of the impact of antiparasitic drug moxidectin on the rewarding effects of alcohol.

Alcohol addiction or alcoholism constitutes a significant risk factor worldwide for morbidity and mortality. Moxidectin is a recently approved anthelmintic drug, which also activates the gamma-aminobutyric acid receptors. The objective of the present study was to examine the impact of moxidectin on rewarding effects of ethanol in the conditioned place preference (CPP) model in mice. In separate experiments, mice were administered intraperitoneal (i.p.) injections of moxidectin (5 or 10 mg/kg, i.p.) before a) acquisition of alcohol-induced CPP, b) each extinction session, and c) alcohol-induced reinstatement of CPP. The present experiments provide consistent data about ethanol place preference in mice (2 g/kg, i.p.), with mice in all tests spending significantly more time on the ethanol-paired side. The acquisition of the CPP response to ethanol was prevented by the administration of moxidectin at a dose of 10 mg/kg. Additionally, moxidectin treatment accelerated the extinction of ethanol CPP when given repeatedly during the extinction phase. Ethanol-induced reinstatement of CPP following an extinction phase was inhibited by moxidectin. Ethanol alone and co-administration with moxidectin did not change locomotor activity and motor coordination. In conclusion, we suggest that moxidectin may be a promising therapeutic candidate for prevention of ethanol-induced addiction and relapse as well as detoxification.

Evaluation of eye care and ocular findings in critically ill COVID-19 patients.

OBJECTIVE: The current study aimed to evaluate eyecare needs along with ocular findings in patients treated in intensive care units because of Covid-19 infection. MATERIALS AND METHODS: A total of 93 patients, 58 men and 35 women, who were under follow-up and treatment in intensive care because of COVID-19 infection from 1 January 2021 to 15 February 2021 were included in the study. Detailed eye examinations of the patients were performed with a portable handheld biomicroscope, direct and indirect ophthalmoscope. Cases requiring treatment for eye diseases were identified and treated. RESULTS: The mean patient age was 68.32 ± 9.97 years; 35 patients were followed up and treated with non-invasive mechanical ventilation and 58 patients with invasive mechanical ventilation support. Mild, moderate, and severe chemosis was observed in 19 patients (20.4%), 10 patients (10.8%) and 4 patients (4.3%), respectively. Conjunctivitis (8.6%) was observed in eight patients. Corneal abrasion was present in seven patients (7.5%). Keratitis secondary to exposure keratopathy was observed in one patient. Eye care and medical treatment were initiated for these patients. We noted eight patients (8.6%) with retinal haemorrhage; however, to the best of our knowledge, these patients may show acute retinal involvement secondary to systemic diseases or have previous retinal findings other than Covid-19 infection or treatments. CONCLUSION: Findings of ocular involvement because of COVID-19 infection were detected in the present study. Retinal haemorrhages were detected in addition to the common findings in viral infections. Especially in patients supported with mechanical ventilation, the detection and treatment of conditions that require eye care for exposure keratopathy are very important for recovering from the disease and the quality of vision.

Serum 25(OH)D Deficiency and High D-Dimer Levels are Associated with COVID-19 Pneumonia.

BACKGROUND: To identify the risk factors for COVID-19 pneumonia and to characterize the epidemiology of the disease. METHODS: This was a prospective study of consecutive patients with SARS-CoV-2 infection and respiratory symptoms, enrolled between April 12 and April 30 of 2020. Pneumonia was diagnosed on the basis of abnormal chest CT findings. At admission, we performed a complete blood count, as well as determining serum levels of CRP, procalcitonin, D-dimer, ferritin, LDH, and 25-hydroxyvitamin D (25[OH]D). Comorbidities, body mass index (BMI), and smoking habits were noted. We also analyzed the risk factors for development of COVID-19 pneumonia. RESULTS: We evaluated 124 patients (79 males) with a mean age of 38 ± 16.6 years. Fever was observed in 67 patients (54.0%), fatigue, cough, and dyspnea being observed in 94 (75.8%), 86 (69.3%), and 37 (29.8%), respectively. Of the 124 patients, 77 (62.1%) developed pneumonia. Common comorbidities in the patients with pneumonia were hypertension, diabetes, and cardiovascular disease. D-dimer > 0.5 µg/mL (OR = 8.6; 95% CI: 3.32 - 22.26, p < 0.001); 25(OH)D < 20 µg/dL (OR = 6.75; 95% CI: 2.81 - 16.21, p < 0.001); and age > 60 years (OR = 15.66; 95% CI: 2.02 - 121.40, p < 0.001) were variables showing significant correlation with COVID-19 pneumonia. CONCLUSIONS: Serum 25(OH)D deficiency, high D-dimer levels, and advanced age are associated with a greater risk of developing COVID-19 pneumonia.

Effect of the coronavirus pandemic on tumor markers.

The new type of coronavirus could cause severe acute respiratory syndrome and injuries in other systems as well. Multiple organ damage can occur rapidly in patients infected with coronavirus disease 2019 (COVID-19). Previous studies have shown that many laboratory biomarkers were not within the normal ranges in COVID-19 patients. We aimed to summarize laboratory parameters and the tumor markers in COVID-19 patients. This is a retrospective cohort study conducted on 53 women between the ages of 19-85 years infected with COVID-19 at a training and research hospital between May 2020 and August 2020. Of the 53 women, 16 (30.2%) had leukopenia. The mean C-reactive protein level was 18.42 ± 59.33 mg/L. The mean procalcitonin level was 0.1 ± 0.21 µg/L. The liver function tests were within normal limits. The mean creatinine level was 0.58 ± 0.37 mg/dl. Elevated levels of α-fetoprotein (AFP) in 1 patient, elevated levels of carcinoembryonic antigen (CEA) in 2 patients, elevated levels of cancer antigen 125 (CA125) in 4 patients, elevated levels of CA19-9 in 2 patients, and elevated levels of CA15-3 in 2 patients were detected. One of 4 patients who were taken to the intensive care unit had elevated levels of AFP. In addition, 2 of 4 patients who were taken to the intensive care unit had elevated levels of CA125 and CA15-3. Except for AFP, levels of all tumor markers of the patient who died were high. We found that COVID-19 had no effect on tumor markers (CA125, CA19-9, CA15-3, AFP, and CEA).

Evaluation of seroprevalence and clinical and laboratory findings of patients admitted to health institutions in Gümüshane with suspicion of Crimean-Congo hemorrhagic fever

Background/aim: To determine the seroprevalence and evaluate clinical findings and laboratory results of patients prediagnosed with Crimean-Congo hemorrhagic fever (CCHF) in Gümüshane. Materials and methods: Included in the cross-sectional study were 362 patients (162 female, 200 male) between 0 and 94 years of age, who were followed up after receiving a preliminary diagnosis of CCHF between January 2011 and December 2019. Anamnesis, age, sex, clinical findings, laboratory results, epidemiological and clinical evaluations, severity criteria, risk factor reviews, and a comparison of the suspected negative cases with positive cases were analyzed retrospectively. Patients included in the study were evaluated as RNA- positive by polymerase chain reaction (PCR) or IgM-positive by ELISA. Results: Of the 362 patients admitted to health institutions with a preliminary diagnosis of CCHF, 242 were diagnosed as CCHF- positive (66.9%). Moreover, 196 of those CCHF-positive patients (81%) were admitted to health institutions during the summer months. Statistical analyses revealed a significant relationship between the incidence of CCHF and patients who had been in contact with animals, lived in rural areas, and had engaged in farming and animal husbandry. In addition, fever, headache, diffuse bodily pain, nausea and vomiting, diarrhea, fever of 38 °C or higher, tachycardia, elevated ALT/AST, creatine kinase (CK), and lactate dehydrogenase (LDH) levels, leukopenia, and thrombocytopenia were detected in the CCHF-positive patients. Significant relations were found between this disease and these symptoms. However, there was no significant relationship between the statistical evaluation of the disease and bloody diarrhea, bodily bruises, rash, unconsciousness, gingival bleeding, hypotension, epistaxis, petechiae, splenomegaly, ecchymosis, hematuria, maculopapular rash, gastrointestinal system complaints, anemia, or elevation of the international normalized ratio and activated partial thromboplastin time duration, separately. Conclusion: Of the 362 patients, 66.9% (242) of those who received a preliminary diagnosis of CCHF were indeed CCHF-positive in Gümüshane. It was concluded that CCHF remains an important endemic disease in Gümüshane. In addition, elevated ALT/AST, CK, and LDH levels, leukopenia, and thrombocytopenia in patients presenting with headache, fever, fever of 38 °C or higher, generalized body pain, nausea/vomiting, diarrhea, and tachycardia will play a pivotal role in the preliminary diagnosis of CCHF.

Microorganisms and antibiotic susceptibilities isolated from urine cultures.

OBJECTIVES: Urinary tract infection (UTI) is the second most common cause of infection among all infectious diseases at hospitals. Antibiogram results are needed to maintain treatment in patients with suspected UTI. However, empirical antibiotic treatment is initiated in patients since it takes time to obtain the results of antibiograms. The aim of this study was to evaluate the urine culture and antibiogram results of patients who were admitted to our hospital with suspected UTI and compare the results with other studies. METHODS: Urine cultures requested from the hospital information system database between January of 2018 and 2019 were analyzed. Microorganism-positive urine samples and antibiogram results were evaluated and included in the study. RESULTS: Of the patients, 748 (61.8%) were female and 463 (38.2%) were male. The average age of all patients was 44.9 years. Escherichia coli was the most frequently isolated microorganisms from urine cultures (n = 828, 68.4%). Among all microorganism-positive urine samples, antibiotic resistance against Cefalexin, Fusidic acid, Ampicillin, Erythromycin, Levofloxacin, Cefuroxime Axetil, Trimethoprim/ Sulfamethoxazole, Ceftriaxone and Ciprofloxacin was 83.9%, 68.4%, 61.8%, 44.7%, 42.7%, 36.4%, 30%, 28.6% and 26.7%, respectively. CONCLUSIONS: High resistance to Cefalexin, Ampicillin, Cefuroxime, Axetil, Trimethoprim/ Sulfamethoxazole, Ceftriaxone and Ciprofloxacin, which are often preferred in empirical antibiotic selection, has been found. We believe that empirical antibiotic selection should not be overlooked in cases of UTI. Our study may help clinicians use appropriate antibiotics for the clinical management of UTIs.

[Evaluation of the reproductive potential of Encephalitozoon intestinalis in four different cell line]. / Encephalitozoon intestinalis'in dört farkli hücre hattinda üreme potansiyelinin degerlendirilmesi.

Microsporidia are parasites that can cause infections in many vertebrate and invertebrate organisms and produce small spores resistant to environmental conditions. As they are obligate intracellular parasites, axenic cultures cannot be performed. The aim of this study was to investigate the reproductive potential of the parasite in human colon epidermal adenocarcinoma (Caco-2), human monocytic (U937), African green monkey renal epithelial (VERO) and human kidney epithelial (HEK-293) cell lines of tissue and organs where the parasite is located by following the culture of the parasites and the amount of spores for six weeks. RPMI-1640 medium was used for the cultivation of U937 cells, while DMEM was used for other cell lines and the immature U937 cells were stimulated with Phorbol-12-Myristate-13-Acetate before infection. All of the host cell groups were infected with freshly collected Encephalitozoon intestinalis spores in ratio 1:30 and free spores in the culture media were removed after overnight incubation at 37°C under 5% CO2 condition for parasite invasion. The first release of the spores from the infected cells was observed and recorded by following for six weeks. Furthermore, the spore density released from each cell groups was evaluated by measuring the parasite load by Thoma cell counting chamber and quantified by real-time PCR. As a result of the study, it was observed that four cell lines could be infected by E.intestinalis and the spore production can be maintained for six weeks. It was observed that the monolayer macrophages and CaCo-2 cells, started to be detached from the culture flasks in few days following the parasite invasion, thus decreasing the number of host cells. After 1-2 weeks, HEK-293 cells were also detached from the surface, thus negatively affected the pure spore production by contaminating the media with dead host cell suspension. Spores started to appear in VERO cell media at the end of the second week after initial infection, while it took longer time for other cells to start releasing spores. Over the course of six weeks, the VERO cell line had the highest spore-producing potential among the other cell lines. In conclusion, this study compared the potential for reproduction of E.intestinalis in three human cell lines and monkey originated VERO cell line. This study demonstrated that cells derived from the tissues or organs where Microsporidia species causes disseminated infections could be infected by the parasitic spores in vitro. Additionally, the parasite can survive and propagate longer than six weeks. The authors believe that the results of this study will contribute to the further studies related to the parasite in the area of genetics, pharmacology, biochemistry, immunology and eradication studies.