Pulmonary hypertension in the elderly. Is it an overdiagnosis or a distinct entity?

OBJECTIVE: The diagnosis of pulmonary hypertension (PH) in the elderly has become more common, recently. The possibility of overdiagnosis or misdiagnosis may arise in the elderly due to accompanying physiological changes and comorbidities. In this study, we aimed at revealing the clinical findings of individuals aged 60 years and older who were diagnosed with Group 1 and Group 4 PH, and at determining their differences with younger adults. PATIENTS AND METHODS: Patients aged 60 years and older who were diagnosed with PH were identified. Among these patients, patients with a diagnosis of Group 1 PH (PAH) and Group 4 PH (CTEPH) were selected. A control group was formed from young and middle-aged patients. Demographic, clinical and hemadynamic characteristics of the elderly patients and the control group were analyzed. RESULTS: The mean WHO Functional Class and the Charlson Comorbidity Index score were significantly higher; the mean EF was significantly lower in the elderly. The right heart catheterization results were assessed. While the mean PAP was significantly higher in young-middle-aged patients (49.6 vs. 39.2 mmHg) (p=0.03), the mean PCWB was significantly higher in the elderly (11.4 vs. 8.1 mmHg) (p=0.005). The young-middle-aged patients had a significantly higher mean PVR values (10.7 vs. 8.3 WU) (p=0.01). CONCLUSIONS: Comorbidities and age-related functional losses may complicate the diagnosis of PH in elderly. Group 2 PH, which we frequently encounter in the elderly, may mask the true Group 1 or Group 4 PH in these patients. PH should be kept in mind in the elderly patients with unexplained exertional dyspnea.

The relationship between university students' depression, anxiety, and stress with positivity attitudes and the COVID-19 pandemic.

Background: The physical activity of university students is restricted during the pandemic, changes in education and training, and uncertainties during the pandemic caused their social lives to change completely. Aim: This study aims to determine the relationship between the depression, anxiety, and stress, and positivity attitudes of university students during the Covid-19 (coronavirus disease-2019) outbreak and their attitudes and behaviors toward the pandemic. Subjects and Methods: This cross-sectional study was conducted online among university students, n = 2153 from April 30, 2020 to May 10, 2020. Data were collected with the Positivity Scale and the Depression Anxiety Stress Scale. Results: The proportion of those with moderate and above depression, anxiety, and stress symptoms in the study group, respectively, were 40.6%, 24.6%, and 22.5%. The risk ratio of these symptoms is higher among those with lower positive attitudes (OR [odds ratio] = 0.804, 0.897, 0.895, respectively), being women (OR = 1.446, 1.666, 1.471), who are concerned with the transmission of the Covid-19 (OR = 1.144, 1.374, 1.201), who believe their intra-family relations (OR = 1.886, 1.728, 2.083) and education (OR = 1.680, 1.682, 2.132) are negatively affected, and those who are more worried about life after the pandemic. Conclusion: Compared with the pre-pandemic period, the frequency of university students showing symptoms of depression increased, and there was no significant change in anxiety and stress levels.

The views of adult married women living in villages on early marriage and its relation with the perception of health.

Background/Aim: Early marriage is a preventable public health problem that brings along social and health problems as well. This study was performed to determine the views of adult married women, who live in the villages located in the central district of Bitlis which is situated in the eastern region of Turkey, on early marriage and compare their views with their perception of health. Subjects and Methods: Adult married women, who live in the villages located in the central district of Bitlis which is situated in the eastern region of Turkey, constitute the population of this cross-sectional study. Results: Customs and traditions, helping with household chores or agricultural tasks, and bride price are the main factors in preferring these marriages. It has been determined that age (r = 0.100; P = 0.047) and number of children (r = 0.153; P = 0.002) are positively related with health perception, albeit weakly. The median (score: 49) of women having five or more children is significantly higher than women (score: 45) with children in the range of 0-2. Conclusion: Women living in rural areas have a high rate of early marriage, and traditions and customs determine the decision to marry. Age and number of children were found to be positively correlated with perception of health, though weakly. Increasing the perception of health before and during the initial years of marriage could help in preventing many adverse effects that are caused by early marriage. With the increase in age and number of children, women might seek more health. This can increase women's health perception.

Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis.

OBJECTIVE: Determining the severity of sarcoidosis is based on the clinical and radiological findings of the disease and the changes in pulmonary function test results. On the other hand; studies are ongoing for objective and easy markers in this respect. Neutrophil/lymphocyte ratio (NLR) is shown as a good prognostic marker for inflammation due to tissue damage in recent clinical trials. In this study, we aimed to identify the possible relationship between NLR and radiological extent of sarcoidosis. PATIENTS AND METHODS: Data of 122 patients included in the study were evaluated retrospectively in terms of age, gender, complete blood count parameters, erythrocyte sedimentation rate (ESR) and radiological findings at the time of diagnosis. RESULTS: Mean NLR and ESR were significantly different between radiological stages according to chest radiography and also total HRCT score (THS) groups according to parenchymal involvement in thorax tomography (p <0.05). Mean NLR was found to be 1.28 in stage 0, 1.65 in stage 1, 2.88 in stage 2,5.47 in stage 3 and 8.48 in stage 4; 1.63 in THS group 1, 2.01 in group 2, 3.47 in group 3 and 5.46 in group 4. There were statistically significant positive correlations between NLR and WBC, NLR and THS, NLR and ESR, THS and ESR, ESR and platelet, WBC and #neutrophil, WBC and #lymphocyte. CONCLUSIONS: Our findings suggest that NLR might be used as a prognostic marker in pulmonary sarcoidosis.

Neospora caninum: the First Demonstration of the Enteroepithelial Stages in the Intestines of a Naturally Infected Dog.

A 1.5-month-old Kangal breed puppy from a dairy cattle farm died after showing severe diarrhoea and incoordination. Necropsy examination revealed multifocal pulmonary consolidation and necrosis and fibrinohaemorrhagic enteritis. Microscopically, there was necrotic and purulent bronchopneumonia, myocarditis and non-purulent encephalitis. In the jejunum and ileum there was villous atrophy and crypt hyperplasia with oocyst-like and schizont-like structures in the epithelia. Immunohistochemically, Neospora caninum antigen was detected in association with the intestinal protozoal structures, degenerative neurons and areas of necrosis in the lungs and heart. Polymerase chain reaction confirmed that the organism was N. caninum and not Toxoplasma gondii. The seroprevalence for N. caninum was 74.2% (49/66 animals) for the cattle and 57.1% (4/7 animals) for dogs on this farm. This report documents fatal systemic neosporosis and enteroepithelial stages of N. caninum in a naturally infected puppy. To the authors' knowledge, this is the first definition of intestinal neosporosis in a naturally infected dog as well as the first evidence of fatal canine neosporosis in Turkey.

Local sympathetic stimulation not only have local effects in patients with Raynaud's phenomenon.

OBJECTIVE: Many other organs and system can be affected in the course of Primary Raynaud's Phenomenon (RP). Simultaneously increased vasospasm in the pulmonary vascular bed may likely affect the pulmonary function. Therefore, we investigated the effect of Raynaud's phenomenon on the respiratory functions in this study. PATIENTS AND METHODS: Between March 2014 and December 2014, 30 patients with the diagnosis of PRP more than two years and 32 age-sex matched healthy controls were enrolled into this study. Cold stimulation test (CST) was performed. Pulmonary function test were performed following 30 minutes after CST and spirometric measurements were calculated. RESULTS: There were no statistically significant differences between two groups regarding their demographic and clinical data. Mean duration of symptoms from onset to present was 3.01 ± 1.05 years. Patients with Primary RP had significantly lower FVC and higher FEV1/FVC values compared to the control groups (p = 0.015 and p=0.045, respectively). CONCLUSIONS: We found that statistically significant decrease of FVC values in patients with Primary RP compared to the healthy controls could be a impaired innervation of pulmonary system and a predictor of pulmonary vasospasm and/or pulmonary Raynaud's phenomenon, which may develop in future periods.

[Investigation of aflatoxin M1 levels in raw and market milks in Mersin Province, Turkey]. / Mersin ilinde cig ve market sütlerinde aflatoksin M1 düzeyinin arastirilmasi.

Aflatoxin M1 (AFM1) which is produced by some Aspergillus species, mainly Aspergillus flavus, is the hydroxylated metabolite of aflatoxin B1 (AFB1) and can be found in milk and dairy products of livestock fed with contaminated feed. AFM1 is a potential threat to human health owing to its toxic and carcino- genic effects. This study was aimed to investigate the level of AFM1 in raw and ultra-high-temperature pasteurized (UHT) milk samples. A total of 137 milk specimens (39 from goats, 53 from cows, and 45 from UHT marketmilks) were included to the study, and AFM1 levels were analyzed by high performance liquid chromatography (HPLC; Aflaprep M immunoaffinity column; R-Biopharm Rhone Ltd., Glasgow) method. AFM1 positivity was detected in 14 (35.8%) goat milk samples, in 46 (86.7%) cow milk samples and 33 (73.3%) UHT milk samples, with the levels ranging from 0.0021 microg/l to 0.8666 microg/I in raw milk, and from 0.001 microg/I to 0.059 microg/I in UHT milk samples. In 10.2% (4/39) of goat milk, 73.5% (39/53) of cow milk, and 2.2% (1/45) of UHT milk samples, the toxin levels were found to be above the officially reasonable limit value (> 0.05 microg/l) recommended by Turkish Food Codex Regulation. Since AFM1 levels were found to be significantly high in the raw milk samples collected in Mersin province (located on Mediterranean part of Turkey), it was concluded that people dealing with feed, milk and dairy products should be informed about the importance of aflatoxins and the preventive measures to get protected from AFB1 and AFM1.

Cellular enzyme values in hunter/jumper and dressage horses with dermatophytosis / Valores de enzimas celulares em cavalos de caça e de esportes com ou sem dermatofitose

Valores de enzimas celulares envolvendo testes da função hepática em 16 equinos de caça e de salto com tricofitose naturalmente adquirida foram comparados com 16 equinos saudáveis, para avaliar os efeitos da doença sobre as atividades dessas enzimas hepáticas. Todos os cavalos diagnosticados com tricofitose ou positivos para Tricophyton equinum foram isolados. Soro aspartato aminotransferase (AST), alanina aminotransferase (ALT), lactato desidrogenase (LDH), fosfatase alcalina (ALP) e gama glutamil transferase (GGT) foram analisados por calorimetria. Não houve diferenças significativas entre os animais doentes e os saudáveis quanto às atividades enzimáticas.

Proliferative response by the ostrich proventriculus in idiopathic gastric stasis: a case report.

In this report, the late clinical, necropsy, and histopathological findings of idiopathic gastric stasis in an ostrich are described, with special attention to the proventriculus. An ostrich with clinical signs of gastric stasis was brought to our clinic in a state of impending death that could not be reversed with emergency medical care. At necropsy, the koilin layer of the gizzard was uneven without ulcerations. The proventriculus was distended with food items without impaction and mucosal lesions. None of the most typical aetiological factors including foreign objects, Macrorhabdus ornithogaster and parasitic infection with Libyostrongylus douglassii was present. Histologically, the proventriculus was characterised by hyperplastic mucosa with luminal buds and necrotic cells in the lumen. Immunochemistry for proliferating cell nuclear antigen (PCNA) revealed a high rate of proliferation in epithelial cells of the glandular and mucosal lining in the proventriculus neighbouring the affected gizzard: approximately 88.6% of the cells were immunoreactive as compared to 34.4% of the cells in control ostriches used for comparison. In conclusion, in the absence of gizzard contraction, the mucosal lining of the proventriculus is hyperplastic with a high rate of proliferation that may help compensate the distension due to the accumulation of food items.

Thiophene-2-carbaldehyde N-(2,4-dinitrophenyl)-N-methylhydrazone.

Molecules of the title compound, C12H10N4O4S, are linked through intermolecular hydrogen bonds to form a dimeric structure. The crystal structure of the dimer is stabilized by two intermolecular hydrogen bonds of the C-H...O type. The C...O intermolecular contact distance is 3.339(3) A, and the C=N and N-N distances are 1.279(2) and 1.371(7) A, respectively. One O atom of the 2-nitro group is disordered over two sites.