Correlation of Clinical Course with Computed Tomography Findings and Biochemical Parameters at the Time of Admission in COVID-19 Patients.

OBJECTIVE: The primary objective of our study was to evaluate the predictive performance of serum inflammatory markers and the semiquantitative computed tomography severity scoring system on diagnosing the Covid 2019 disease and its course. METHODS: Our study is a single-center retrospective cohort study. The data of 213 adults who were confirmed to have coronavirus disease 2019 by polymerase chain reaction tests in the period between April 2020 and August 2020 were evaluated. One hundred eighty four of these patients whose C-reactive protein, d-dimer, and ferritin levels, lymphocyte counts, and thoracic computed tomography images were obtained at the time of admission were included in the study. The semi-quantitative computed tomography severity score was calculated for all patients. RESULTS: The median age of the 184 patients included in the study was 51.5 (19-91) years. The incidence of intensive care need and mortality was 10.3% (n=19) and 5.4% (n=10), respectively. The intensive care need and mortality rate was significantly correlated with higher thoracic computed tomography involvement scores at admission. There was a statistically significant and positive correlation between the computed tomography scores and the C-reactive protein, d-dimer, and ferritin levels. Older age (>65 years-old) and thoracic computed tomography scores of 11 and higher were independent factors correlated with need for intensive care. CONCLUSION: Serum inflammatory markers and semi-quantitative computed tomography severity scoring system were predictive in diagnosing the Covid 2019 disease and its course.

More than tubular dysfunction: cystinosis and kidney outcomes.

BACKGROUND: Cystinosis is a lysosomal storage disease that affects many tissues. Its prognosis depends predominantly on kidney involvement. Cystinosis has three clinical forms: nephropathic infantile, nephropathic juvenile and non-nephropathic adult. Proximal tubular dysfunction is prominent in the infantile form, whereas a combination of glomerular and tubular alterations are observed in the juvenile form. METHODS: Thirty-six children with nephropathic cystinosis were included in the study. Clinical features, molecular genetic diagnoses, and kidney outcomes of the patients were evaluated. RESULTS: Twenty-one children (58.3%) were male. The median age at diagnosis was 18.5 months. Twenty-eight patients (77.8%) had infantile nephropathic cystinosis, while eight (22.2%) had juvenile nephropathic cystinosis. An acute rapid deterioration of the kidney function with proteinuria, hypoalbuminemia, and nephrotic syndrome, was observed in 37.5% of patients with the juvenile form. The mean estimated glomerular filtration rate (eGFR) was 82.31 ± 37.45 ml/min/1.73m2 at diagnosis and 63.10 ± 54.60 ml/min/1.73m2 at the last visit (p = 0.01). Six patients (16.6%) had kidney replacement therapy (KRT) at the last visit. The median age of patients with kidney failure was 122 months. Patients with a spot urine protein/creatinine ratio < 6 mg/mg at the time of diagnosis had better kidney outcomes (p = 0.01). The most common allele was c.451A>G (32.6%). The patients with the most common mutation tended to have higher mean eGFR and lower leukocyte cystine levels than patients with other mutations. CONCLUSION: Glomerulonephritis may be a frequent finding in addition to the well-known tubular dysfunction in patients with cystinosis. Furthermore, our results highlight that the presence of severe proteinuria at the time of diagnosis is a relevant prognostic factor for kidney survival.

Sacroiliitis associated with familial Mediterranean fever in childhood: a case series and review of literature.

BACKGROUND AND OBJECTIVES: Familial Mediterranean fever (FMF) is an autosomal-recessive auto-inflammatory disorder characterized by recurrent episodes of fever with serositis. Sacroiliitis associated with FMF is very rare, especially in children. We aimed to describe the demographic, clinical, laboratory features, and treatment responses of pediatric patients with FMF -related sacroiliitis. METHODS: The study consisted of seven pediatric patients younger than 16 years, diagnosed with sacroiliitis associated with FMF between 2010 and 2017. Medical records of patients were retrospectively evaluated. Sacroiliitis was diagnosed based on magnetic resonance imaging. We also reviewed previous studies of FMF related sacroiliitis. RESULTS: Five of the seven patients (male:female ratio of 5:2) had a M694V (homozygous) mutation, one patient had a M694V (heterozygous) mutation, and one patient had a V726A (heterozygous) mutation. All patients were HLA-B27 negative. One of the cases achieved remission with colchicine plus non-steroidal anti-inflammatory drug treatment, and one patient`s symptoms were managed by the addition of sulfasalazine. Four patients responded to etanercept treatment, and one patient`s symptoms were suppressed with canakinumab. CONCLUSION: Sacroiliitis can be seen in pediatric FMF patients suffering with inflammatory back pain. This manifestation generally occurs in FMF patients who have M694V mutation. Etanercept could likely show a beneficial effect in patients who are resistant to disease modifying anti-rheumatic drugs and non-steroidal anti-inflammatory drugs. In addition, canakinumab treatment should be considered as a successful alternative therapy in this rare group of patients.

Comparison of Direct and Remote Ischaemic Preconditioning of Renal Ischaemia Reperfusion Injury in Rats.

OBJECTIVE: One of the methods that can be used to prevent ischaemia reperfusion (IR) injury is ischaemic preconditioning. The aim of this study was to evaluate and compare the effects of remote and direct ischaemic preconditioning (RIPC and DIPC) histopathologically in the rat renal IR injury model. METHODS: After obtaining an approval from the Dokuz Eylül University School of Medicine Ethics Committee, 28 Wistar Albino male rats were divided into four groups. In Group I (Sham, n=7), laparotomy and left renal pedicle dissection were performed, but nothing else was done. In Group II (IR, n=7), after 45 minutes of left renal pedicle occlusion, reperfusion lasting 4 hours was performed. In Group III (DIPC+IR, n=7), after four cycles of ischaemic preconditioning applied to the left kidney, renal IR was performed. In Group IV (RIPC+IR, n=7), after three cycles of ischaemic preconditioning applied to the left hind leg, renal IR was performed. All rats were sacrificed, and the left kidney was processed for conventional histopathology. RESULTS: The histopathological injury score of the kidney was significantly lower in the sham group compared with the other groups (p<0.01). The injury scores of the DIPC+IR and RIPC+IR groups were significantly lower than in the IR group (p<0.05). In the RIPC+IR group, the injury score for erythrocyte extravasation was found to be significantly lower than in the DIPC+IR group (p<0.05). CONCLUSION: In the present study, it was demonstrated that both DIPC and RIPC decreased renal IR injury, but RIPC was found to be more effective than DIPC. This protective effect requiresfurther detailed experimental and clinical studies.

Urodynamic disorders and renal scarring in pediatric patients with nonmonosymptomatic nocturnal enuresis.

BACKGROUND/AIM: In nonmonosymptomatic nocturnal enuresis (NMNE), the incidence of organic abnormality and urodynamic disorder is more frequent than the general population. The aim of this study is to identify urodynamic disorders and renal scarring in children with NMNE. MATERIALS AND METHODS: This study evaluated the urodynamic disorders and renal scarring of a total of 30 patients who were diagnosed with NMNE. A video-urodynamic test and Tc-99m dimercaptosuccinic acid renal scintigraphy were applied. RESULTS: Records of 605 patients who had been diagnosed with enuresis were analyzed, and 215 (33.5%) of them had been diagnosed with NMNE. Thirty patients older than 6 years old with NMNE were included in the study. Detrusor overactivity was identified in 10 patients. Bladder capacity was low in 5 patients and bladder compliance was low in 2 patients. Renal scarring was identified in 1 patient. Unilateral vesicoureteral reflux was found in 4 patients. CONCLUSION: Bladder function disorder is also a significant risk factor for the development of renal scarring, besides other risk factors. Organic abnormalities are seen more often in patients with NMNE than patients with monosymptomatic nocturnal enuresis, so urodynamic studies should be remembered for patients with NMNE.

On the use of contraceptive methods among married women in Turkey.

OBJECTIVE: To identify factors affecting use and choice of contraceptive methods of married women in Turkey. METHODS: The study is based on data from the 1998 Turkish Demographic and Health Survey, held by the Hacettepe Institute of Population Studies. To analyse the data set, a multinomial logistic regression model has been used. RESULTS: The most influential variable for traditional method use versus non-use is 'region', while that for modern method use versus non-use is a 'woman's attitudes towards family planning methods'. Moreover, modern method use versus traditional method use is more common in middle-aged women, living in urban areas, approving of family planning methods and with higher education. CONCLUSION: Women's behaviours on contraceptive method use and choice are associated with women's attitude towards family planning and level of education as well as region and place of residence; that is, ease of access to the methods. To increase success of family planning programmes, it should be ensured that the methods are easily accessed and women receive information about contraceptive methods. In addition, family planning providers must strive to increase women's level of education.