Epidemiological, clinical, biochemical, and treatment characteristics of brucellosis cases in Turkey.

INTRODUCTION: In our study, we aimed to evaluate the epidemiological features of brucellosis and the efficacy of different treatment options in patients with various organ involvements. METHODOLOGY: Patients diagnosed with brucellosis and treated in two different centers between 2009 and 2019 were retrospectively screened and evaluated regarding epidemiological and clinical features, laboratory findings, and treatment responses. RESULTS: The study included 297 complete-data patients (76% of rural patients were farmers). Farming (76%) and raw dairy (69%) were the main transmission methods. Most patients (98.6%) had positive tube agglutination tests. Ninety-two patients' blood and bodily fluid cultures grew Brucella spp. The incidence of leukopenia was 18.8%, thrombocytopenia 10.7%, anemia 34.3%, and pancytopenia 4.3%. Doxycycline and rifampicin were the major treatments, with streptomycin utilized in osteoarticular patients. Pregnant women with neurobrucellosis took ceftriaxone and trimethoprim-sulfamethoxazole. After one year, 7.1% of patients relapsed. Doxycycline + streptomycin and doxycycline + rifampicin had similar relapse rates (p = 0.799). The double- and triple-antibiotic groups had identical recurrence rates (p = 0.252). CONCLUSIONS: In uncomplicated brucellosis cases doxycycline + streptomycin and doxycycline + rifampicin treatments were equally effective. Again, there is no statistical difference in relapse development rates between double and triple combination treatments in uncomplicated brucellosis cases. Relapsed patients generally miss follow-ups, interrupt therapy, have osteoarticular involvement, and get short-term treatment. Patients with focused participation should be thoroughly checked at diagnosis and medicine, and treatment should be lengthy to prevent relapses.

Evaluation of the cardio-ankle vascular index in COVID-19 patients

SUMMARY OBJECTIVE: This study aimed to investigate the relationship and prognostic significance of cardio-ankle vascular index, which is a measure of arterial stiffness that can lead to endothelial dysfunction and poor cardiovascular issues in COVID-19 patients, with COVID-19. METHODS: The study included 115 patients, of which 65 patients in the case group with Real time reversetranscription-polymerasechainreaction test positive and diagnosed for COVID-19 and 50 volunteers in the control group. Patients with COVID-19 were classified as moderate/severe or mild COVID-19 in the subgroup analysis based on the severity of the disease. We investigated the relationship between cardio-ankle vascular index and COVID-19 by using the VaSera VS-1000 device to automatically measure each patient's cardio-ankle vascular index and ankle-brachial pressure index. RESULTS: The mean age of participants included in the study was 65.7±10.7 years. Patients and volunteers were statistically similar in terms of age, gender, comorbidities, Charlson comorbidity index scores, and body mass index values (p>0.05). The right-cardio-ankle vascular index value was 9.6±2.4 in the case group and 8.5±1.1 in the control group (p=0.004). The left-cardio-ankle vascular index value was 9.4±2.7 in the case group and 8.5±1.2 in the control group (p=0.01). The right-cardio-ankle vascular index value was 10.8±3.4 in the moderate/severe disease group and 8.8±0.9 in the mild disease group (p=0.008). The left-cardio-ankle vascular index value was 10.7±3.6 in the moderate/severe disease group and 8.5±1.5 in the mild disease group (p<0.001). The right-cardio-ankle vascular index and left-cardio-ankle vascular index values were found to be significantly higher in COVID-19 patients in our study. When receiver operating characteristic analysis was performed to distinguish moderate/severe COVID-19 patients from mild patients, right-cardio-ankle vascular index was area under the curve 0.757 (0.630-0.884), and left-cardio-ankle vascular index was area under the curve 0.782 (0.661-0.902). CONCLUSION: The right-cardio-ankle vascular index and left-cardio-ankle vascular index values increased in COVID-19 patients in our study, and this was thought to be prognostically significant.

Comparison of two pandemics: H1N1 and SARS-CoV-2

SUMMARY OBJECTIVE: We aimed to compare the clinical, epidemiological, and prognostic features of the H1N1 pandemic in 2009 and the severe acute respiratory syndrome coronavirus 2 pandemic in 2020. METHODS: This retrospective study involved subjects from seven centers that were admitted and found to be positive for H1N1 or COVID-19 real-time polymerase chain reaction test. RESULTS: A total of 143 patients with H1N1 and 309 patients with COVID-19 were involved in the study. H1N1 patients were younger than COVID-19 ones. While 58.7% of H1N1 patients were female, 57.9% of COVID-19 patients were male. Complaints of fever, cough, sputum, sore throat, myalgia, weakness, headache, and shortness of breath in H1N1 patients were statistically higher than in COVID-19 ones. The duration of symptoms until H1N1 patients were admitted to the hospital was shorter than that for COVID-19 patients. Leukopenia was more common in COVID-19 patients. C-reactive protein levels were higher in COVID-19 patients, while lactate dehydrogenase levels were higher in H1N1 ones. The mortality rate was also higher in H1N1 cases. CONCLUSIONS: The severe acute respiratory syndrome coronavirus 2 pandemic is a major public health problem that continues to affect the world with its high rate of contagion. In addition, no vaccines or a specific drug for the benefit of millions of people have been found yet. The H1N1 pandemic is an epidemic that affected the whole world about ten years ago and was prevented by the development of vaccines at a short period. Experience in the H1N1 pandemic may be the guide to prevent the COVID-19 pandemic from a worse end.