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OBJECTIVES: The aims of the study are to compare the body composition parameters (BCPs), which have been reported to have a prognostic impact, in COVID-19 patients, and to determine the most influential BCP(s) on the prognosis. METHODS: Unenhanced chest computed tomography examinations of COVID-19 cases were assessed regarding the severity of pneumonia, pectoralis muscle area and density (PMA, PMD), visceral adipose tissue area (VAA), waist circumference, waist to paravertebral muscle circumference ratio, coronary artery calcification severity, and paravertebral muscle area at the T5 vertebral level. A second observer repeated measurements and an intraclass correlation coefficient score were used for interobserver agreement. The relationship between data and patient outcomes (intubation, death) was investigated using multivariable logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of BCPs in predicting outcomes. RESULTS: A total of 238 (121 males, median age, 48 years [interquartile range, 36-63 years]) consecutive COVID-19 patients with chest computed tomography were investigated. Twenty-four patients (10.08%) were intubated, and 15 patients (6.3%) died during at least 1 month of follow-up. Waist to paravertebral muscle circumference ratio, PMA, PMD, and T5 vertebral level were significantly associated with intubation in the multivariable analysis. Pectoralis muscle density and PMA were significantly associated with death. Pectoralis muscle density showed the highest AUC for the prediction of intubation and death (AUC of 0.814 and 0.871, respectively). There was a good to excellent agreement between observers (intraclass correlation coefficient range, 0.899-0.998). CONCLUSIONS: Pectoralis muscle density is the most influential BCP in predicting intubation and death in COVID-19 patients.
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COVID-19 , Masculino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Prognóstico , Tórax , Composição Corporal , Estudos RetrospectivosRESUMO
The potential effects of nanoparticles (NPs) on biological treatment processes have become significant due to their increasing industrial applications. The purpose of this research was to investigate the self-recovery ability of anammox bacteria following acute ZnO NPs toxicity. In this context, a 2-liter lab-scale anammox reactor was operated for 550 days to enrich the biomass required to the batch exposure tests. Anammox culture was firstly exposed to four different doses of ZnO NPs (50, 75, 100 and 200 mg/L) for 24 h. Then, the ZnO NPs were removed and self-recovery performance of the anammox bacteria was assessed by evaluating the nitrogen removal capacities for 72 h. Besides the nitrogen removal performance, extracellular polymeric substances (EPS) production was also detected to deeply understand the response of the enriched anammox culture against ZnO NPs exposure. The results revealed that sudden and high load of ZnO NPs (100 and 200 mg/L) resulted in persistent impairment to the nitrogen removal performance of the enriched anammox culture. However, relatively lower doses (50 and 75 mg/L) caused deceleration of the nitrogen removal performance during the recovery period. In addition, EPS content in the reactor decreased along with escalating load of ZnO NPs.
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Compostos de Amônio , Nanopartículas , Óxido de Zinco , Oxidação Anaeróbia da Amônia , Anaerobiose , Bactérias , Reatores Biológicos , Nanopartículas/toxicidade , Óxido de Zinco/toxicidadeRESUMO
BACKGROUND: CoronaVac is an inactivated virus-based COVID-19 vaccine used in Turkey and approved for emergency use by the World Health Organization (WHO). In this study, it was aimed to retrospectively evaluate the mutation status and clinical status in individuals who received two doses of CoronaVac vaccine and were infected with COVID-19 at least two weeks after the second dose. METHODS: 164 people were included in the study and COVID-19 diagnosis and mutation analyses were determined by RT-PCR using the Bioseepdy SARS CoV-2 Double Gene RT-qPCR Kit and the Biospeedy SARS-CoV-2 Variant Plus kit in accordance with the protocol determined by the manufacturer. RESULTS: 116 (70.7%) UK (Alpha, B.1.1.7) mutation and 3 (1.8%) South Africa (Beta, B.1.351), Brazil (Gamma, P.1) mutations were determined in 164 double doses CoronaVac vaccinated patients; 45 (27.5%) patients were mutation negative. Nine patients (5.5%) developed pneumonia. Eight patients (4.9%) had CT findings compatible with corona virus infection. Seven (4.3%) of the patients received treatment in the intensive care unit, and 5 (3%) of the patients were intubated. DISCUSSION: In conclusion, people who receive two doses of CoronaVac vaccine can be reinfected with mutant viruses, vaccine significantly reduces the need for hospitalization, CT findings and intensive care.
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COVID-19 , Vacinas , Humanos , SARS-CoV-2/genética , COVID-19/diagnóstico , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Turquia/epidemiologia , Teste para COVID-19 , Estudos Retrospectivos , Reação em Cadeia da Polimerase , Mutação , Anticorpos AntiviraisRESUMO
In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to present the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction; only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detection of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.
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COVID-19 , Transtornos do Sono-Vigília , Humanos , COVID-19/complicações , Estudos Retrospectivos , SARS-CoV-2 , Cefaleia/etiologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologiaRESUMO
Neutropenic enterocolitis is also known as typhlitis, is characterized by severe inflammation in the bowel loops. It is often seen in immunosuppressed patients, and it has high morbidity and mortality. Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system and causes COVID-19 (Coronavirus Disease 2019), it may affect hematopoietic and gastrointestinal systems. Herein, we present a rare case of COVID-19-associated pancytopenia and typhlitis in a 60-year-old female who presented with abdominal pain. Contrast-enhanced abdominal computed tomography (CT) demonstrated the bowel wall thickening in the cecum and ascending colon compatible with enterocolitis. Moreover, the chest CT showed bilateral, peripheral, and multifocal ground-glass opacities, consistent with COVID-19 pneumonia. We also aimed to emphasize the laboratory, clinical, and CT findings of the patient.
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COVID-19/complicações , Colo/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pancitopenia/etiologia , Tomografia Computadorizada por Raios X/métodos , Tiflite/etiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pancitopenia/diagnóstico , Pandemias , SARS-CoV-2 , Tiflite/diagnósticoRESUMO
Background/aim: To investigate the relationship between imaging findings and peripheral blood cell counts of COVID-19 patients and the degree of thymus fat involution of these patients. Materials and methods: Computed tomography (CT) images of 87 patients with COVID-19 positive through RT-PCR testing were evaluated retrospectively by two radiologists. Ground glass densities and other signs of viral pneumonia were recorded, lung involvement was scored quantitatively. The patients thymus fat involution was graded on CT. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratios (PLR), lymphocyte and platelet counts were calculated. Imaging findings and degrees of thymus fat involution were compared with laboratory data. Results: Quantitative scoring of lung involvement was calculated at mean 6.63 ± 4.70 (123) for observer 1 and mean 6.55 ± 4.65 (123) for observer 2 (K = 0.8241.000). Statistical significance was determined between the increase in age and the increase in scores of lung findings (p = 0.003). Lymphocyte count (p = 0.0001) and PLR (p = 0.001) were significantly lower in patients with severe CT involvement. A statistically significantcorrelation was found between increased thymus fat component and presence of COVID-19 lung involvement in CT (r = 0.461). Conclusion: The severity of imaging findings for COVID-19 patients significantly correlates with the degree of fat involution in patients' thymus tissue.
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COVID-19/diagnóstico , Pulmão/diagnóstico por imagem , Pandemias , Timo/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , COVID-19/sangue , COVID-19/epidemiologia , Feminino , Seguimentos , Humanos , Contagem de Linfócitos , Masculino , Contagem de Plaquetas , Estudos Retrospectivos , Índice de Gravidade de Doença , Turquia/epidemiologia , Adulto JovemRESUMO
Tularemia is a zoonotic infectious disease caused by Francisella tularensis. In Yozgat, a total of 525 cases were identified between 2010 and 2016. A serious epidemic occurred with a total of 442 cases in 2010 and 2011 and the number of cases decreased in the later years. In our study, we investigated the association of seasonal factors (temperature, humidity, amount of precipitation, wind speed) with the tularemia epidemic which occurred in 2010 and 2011 and with the decrease in the number of cases in the later years. This study included tularemia cases seen in Yozgat and its districts between 2010 and 2016. Tularemia was defined as a microagglutination test (MAT) result of ≥ 1/160 or a 4-fold increase in MAT titer between two tests at least two weeks apart, in the presence of consistent clinical findings. Seasonal factors were recorded. The conformity of data to normal distribution was analyzed using the ShapiroWilk test. The Mann-Whitney U test was used with the results of Monte Carlo simulations to compare differences between two independent groups in terms of quantitative data. It was found that tularemia cases are more frequently seen in the spring and winter. Meteorological data showed that wind force was statistically significantly higher in the epidemic years than in the other years (p< 0.05). No statistically significant difference was found between mean air temperature, amount of precipitation, and humidity (p> 0.05). Our study found that wind velocity was significantly higher in the epidemic years than in the other years (p< 0.05) and this increase in wind velocity may have caused an increase in tick population and distribution. We believe that, rather than causing direct transmission of tularemia to humans, the increased tick population plays a key role in the maintenance of the life cycle of tularemia by causing transmission to rodents and domestic animals.
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Surtos de Doenças , Estações do Ano , Tularemia , Animais , Francisella tularensis/fisiologia , Humanos , Tularemia/epidemiologia , Turquia/epidemiologia , Zoonoses/parasitologiaRESUMO
- Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonosis. The incidence of zoonotic diseases has been shown to be affected by climatic factors. In this study, we evaluated patients endemic to the CCHF region and examined the relationship between the number of patients and climatic properties of the region where they lived. The study included 548 CCHF patients. Along with the patient demographic and clinical characteristics, we recorded temperature, humidity and precipitation in the places where they lived at the time of their admission to the hospital. In addition to temperature, humidity and precipitation at the time of patient admission, these values were assessed at one month and three months prior to admission. The relationship between the number of patients and the above-mentioned values was examined. Humidity at the time of and one month prior to hospital admission, and precipitation three months prior to hospital admission were found to affect the number of patients admitted to the hospital for CCHF. In conclusion, climate appeared to affect the number of CCHF patients. We believe that the number of patients presenting to the hospital with CCHF could be predicted by taking into account climatic properties of the places where CCHF has been recorded, along with undertaking necessary measures.
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Clima , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Hospitalização/estatística & dados numéricos , Doenças Transmitidas por Carrapatos , Adulto , Doenças Endêmicas/estatística & dados numéricos , Feminino , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Vírus da Febre Hemorrágica da Crimeia-Congo/fisiologia , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/terapia , Febre Hemorrágica da Crimeia/virologia , Humanos , Umidade , Incidência , Masculino , Chuva , Estações do Ano , Temperatura , Doenças Transmitidas por Carrapatos/epidemiologia , Doenças Transmitidas por Carrapatos/terapia , Doenças Transmitidas por Carrapatos/virologia , Turquia/epidemiologiaRESUMO
The role of hydrazine (N2H4) in anammox metabolism has been widely studied; however, studies on N2H4 biosynthesis by anammox bacteria are limited in the literature. In this context, the current research aims to investigate the enhancement of biological N2H4 production in the anammox process in a long-term manner. The experimental studies started with the optimization of the operating conditions to achieve maximum N2H4 accumulation. Under favorable conditions (pH = 8.97 ± 0.08; T = 35.5 ± 0.5 °C; initial hydroxylamine dose = 1.46 ± 0.01 mM), 17.16 ± 0.64 mg L-1 of N2H4 accumulated in the batch systems. The continuity of N2H4 bioproduction was then evaluated by long-term observations. A continuous flow bioreactor was operated in four consecutive manipulated periods under optimized conditions. In the long-term operated bioreactor, 55.10 ± 0.30 mg L-1 N2H4 was accumulated at optimal conditions, which was 2.5 times higher than reported in the literature. Although manipulation of the bioreactor operating conditions initially resulted in a significant increase in N2H4 bioaccumulation, it subsequently caused a severe deterioration in anammox activity. However, this could be mitigated by increasing the biomass concentration in the anammox systems. In addition, the relative abundance of Candidatus Kuenenia decreased by 1.88% throughout the long-term operation.
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Reatores Biológicos , Hidrazinas , Reatores Biológicos/microbiologia , Hidrazinas/metabolismo , Anaerobiose , Bactérias/metabolismo , Oxirredução , BiomassaRESUMO
INTRODUCTION: This study aimed to investigate the factors influencing the diagnostic yield of microbiologic diagnosis obtained through percutaneous abdominal abscess drainage procedures. We analyzed the influence of diverse clinical, radiological, and pre-procedural factors on the success of microbiologic diagnosis in this context. METHODOLOGY: A retrospective analysis of patients who underwent percutaneous abdominal abscess drainage was performed to assess the factors affecting the diagnostic yield for microbiologic diagnosis. RESULTS: A total of 174 patients undergoing percutaneous abdominal abscess drainage was included. The use of antibiotics during the procedure and the spread of the abscess to other organs significantly increased the likelihood of obtaining a positive culture. Specifically, antibiotic use during the procedure raised the risk by up to 3.30-fold (OR = 3.30, 95% CI 1.48-7.65, p = 0.004), while abscess spread to another organ increased the risk by approximately 1.87-fold (OR = 1.87, 95% CI 0.98-3.61, p = 0.057). Additionally, abscesses containing air and abscesses with an air-fluid level were more common in patients with positive culture results. Other factors, such as gender, age, malignancy prevalence, and surgical history, did not significantly impact culture results. CONCLUSIONS: This study provides valuable insights into the factors affecting the diagnostic yield of microbiologic diagnosis from percutaneous abdominal abscess drainage. The findings underscore the importance of considering patient-specific variables and procedural aspects when planning and executing abscess drainage procedures. Further research can build upon these insights to develop evidence-based guidelines for optimizing the diagnostic yield of percutaneous abdominal abscess drainage procedures.
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Abscesso Abdominal , Drenagem , Humanos , Estudos Retrospectivos , Masculino , Drenagem/métodos , Feminino , Abscesso Abdominal/diagnóstico , Abscesso Abdominal/microbiologia , Pessoa de Meia-Idade , Idoso , Adulto , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêuticoRESUMO
BACKGROUND: In 2023, Türkiye experienced a significant earthquake disaster that profoundly impacted 11 provinces. The enduring consequences of these earthquakes on daily life triggered widespread fears and anxieties in society, leading to scholarly investigations in this field. OBJECTIVE: The primary objective of this study was to create and evaluate the psychometric properties of the Fear of Earthquake Scale (FES), a modified adaptation of the Fear of COVID-19 Scale (FCV-19 S), tailored to measure earthquake-related experiences in Türkiye. METHODS: A total of 315 Turkish adult participants (106 men, 209 women), with a mean age of 37.71 years, completed the FES, along with the Brief Psychological Resilience Scale (BPRS). Psychometric analyses included confirmatory factor analysis as well as the evaluation of alternative factor structures, internal consistency, convergent validity, and criterion validity with respect to resilience. RESULTS: The findings indicate that the Turkish version of the Fear of Earthquake Scale has strong psychometric properties in terms of validity and reliability. After assessing various factor structures, it was observed that the two-factor model which represents the emotional and somatic response to fear, exhibited the best-fit values The Cronbach's alpha coefficients were calculated as 0.89 for the overall FES, 0.84 for the emotional subscale and 0.86 for the somatic subscale, indicating high internal consistency. Additionally, the negative correlation between resilience and the FES supports the criterion validity of the scale, and multi-group confirmatory factor analyses proved that measurement invariance held across genders and whether they experienced an earthquake or not for all groups. Furthermore, the results of the study revealed that women and individuals with prior earthquake experience reported higher levels of fear of earthquakes. CONCLUSIONS: The FES emerged as a reliable and valid tool for assessing earthquake-related fears among the Turkish population.
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Terremotos , Adulto , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Turquia , Inquéritos e Questionários , Medo/psicologia , PsicometriaRESUMO
INTRODUCTION: Klebsiella pneumonia causes serious infections in hospitalized patients. In recent years, carbapenem-resistant infections increased in the world. The molecular epidemiological investigation of carbapenem-resistant K. pneumoniae isolates was aimed in this study. METHODOLOGY: Fifty carbapenem-resistant K. pneumoniae isolates from six geographical regions of Turkey between September 2019-2020 were included in the study. The disk diffusion method was used for the antibiotic susceptibility testing. The microdilution confirmed colistin susceptibility. Genetic diversity was investigated by MLST (Multi-Locus Sequence Typing). RESULTS: The resistance rates were as follows: 49 (98%) for meropenem, 47 (94%) imipenem, 50 (100%) ertapenem, 30 (60%) colistin and amoxicillin-clavulanate, 49 (98%) ceftriaxone, 48 (96%) cefepime, 50 (100%) piperacillin-tazobactam, 47 (94%) ciprofloxacin, 40 (80%) amikacin, 37 (74%) gentamicin. An isolate resistant to colistin by disk diffusion was found as susceptible to microdilution. ST 2096 was the most common (n:16) sequence type by MLST. ST 101 (n:7), ST14 (n:6), ST 147 and ST 15 (n:4), ST391 (n:3), ST 377 and ST16 (n:2), ST22, ST 307, ST 985, ST 336, ST 345, and ST 3681 (n:1) were classified in other isolates. In Istanbul and Ankara ST2096 was common. Among Turkey isolates, the most common clonal complexes (CC) were CC14 (n:26) and CC11 (n = 7). CONCLUSIONS: In Turkey, a polyclonal population of CC14 throughout the country and inter-hospital spread were indicated. The use of molecular typing tools will highlight understanding the transmission dynamics.
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Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Klebsiella , Humanos , Antibacterianos/farmacologia , Colistina , Tipagem de Sequências Multilocus , Klebsiella pneumoniae , Turquia/epidemiologia , beta-Lactamases/genética , Farmacorresistência Bacteriana Múltipla/genética , Carbapenêmicos/farmacologia , Infecções por Klebsiella/epidemiologia , Unidades de Terapia Intensiva , Testes de Sensibilidade MicrobianaRESUMO
INTRODUCTION: COVID-19 disease is more serious and fatal in patients on dialysis treatment due to their immunosuppressive status. In this study, we aimed to evaluate the protection and safety of Sinovac vaccine, which is an inactivated vaccine, in patients undergoing hemodialysis. METHODOLOGY: A control group consisting of 220 hemodialysis patients (HD group) and 648 healthcare professionals who were healthy in our institution were included in the study. Quant II IgG anti-Spike antibody was measured 3 weeks after two doses of Sinovac vaccine were administered to both groups. RESULTS: The antibody response after two doses of Sinovac vaccine was 85.2% in the HD group and 99.8% in the control group. The mean antibody level before vaccination in the HD group was 3.5 ± 7.2 AU/mL and increased significantly 3 weeks after two doses of vaccine (mean 751 ± 1196 AU/mL). The control group's mean antibody level after vaccination was 1723 ± 1878 AU/mL. The mean antibody level after vaccination in the control group was significantly higher than the HD group (p < 0.0001). Despite higher levels of anti-Spike antibodies in the control group, post-vaccination antibody response was acceptable in both HD and control groups. The HD group was significantly older (mean 64 ± 12 years) than the control group (36 ± 10 years) (p < 0.0001). CONCLUSIONS: Although dialysis patients are immunocompromised, and some may not develop antibodies to the virus as strongly as healthy people, this study revealed that dialysis patients developed significant amounts of antibodies. Being old or on dialysis is an independent predictor of low antibody response to the Sinovac vaccine.
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COVID-19 , Vacinas , Humanos , Diálise Renal , Vacinação , Imunoglobulina G , Anticorpos AntiviraisRESUMO
INTRODUCTION: The reactivation of CMV (Cytomegalovirus) in renal transplant recipients may be manifested across a clinical spectrum from asymptomatic viraemia to organ rejection. The purpose of this study is to evaluate the patients who have experienced CMV infection after renal transplantation in the last twelve years, and to assess the efficacy of valacyclovir. METHODOLOGY: Renal transplant recipients' demographic, clinical and laboratory data were evaluated retrospectively between 2006-2018. Valaciclovir was given at the standard prophylaxis dose of 2000 mg/daily. CMV Polymerase Chain reaction (PCR) was performed in 2-week intervals until 1 year after transplantation, and upon any symptoms attributable to CMV. RESULTS: The entire study group had D+/R+ (donor-positive, recipient-positive) serological status of the CMV virus. 171 (59.2%) patients had only CMV infection, 60 (20.8%) had overall CMV antigen positivity until the end of the follow-up period and 7 (2.4%) patients had CMV disease. Rejection episodes were diagnosed in 31 (10.8%) patients; 20 (64.5%) of those were PCR positive for CMV; mortality rate was 12 (4.2%) but those who died had a non-CMV related disease. CONCLUSIONS: Valaciclovir may be preferred in prophylaxis instead of valganciclovir as we used in our study since valganciclovir has prolonged treatment time, rapid development of drug resistance, drug toxicity and high cost.
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Infecções por Citomegalovirus , Transplante de Rim , Humanos , Valaciclovir/uso terapêutico , Valganciclovir/uso terapêutico , Antivirais/uso terapêutico , Ganciclovir/uso terapêutico , Transplante de Rim/efeitos adversos , Estudos Retrospectivos , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/prevenção & controle , Imunoglobulina GRESUMO
Nonylphenol (NP) is a bioaccumulative environmental estrogen that is widely used as a nonionic surfactant. We have previously examined short-term effects of NP on yeast cells using microarray technology. In the present study, we investigated the adaptive response of Saccharomyces cerevisiae BY4742 cells to NP exposure by analyzing genome-wide transcriptional profiles using RNA-sequencing. We used 2 mg/L NP concentration for 40 days of exposure. Gene expression analysis showed that a total of 948 genes were differentially expressed. Of these, 834 genes were downregulated, while 114 genes were significantly upregulated. GO enrichment analysis revealed that 369 GO terms were significantly affected by NP exposure. Further analysis showed that many of the differentially expressed genes were associated with oxidative phosphorylation, iron and copper acquisition, autophagy, pleiotropic drug resistance and cell cycle progression related processes such as DNA and mismatch repair, chromosome segregation, spindle checkpoint activity, and kinetochore organization. Overall, these results provide considerable information and a comprehensive understanding of the adaptive response to NP exposure at the gene expression level.
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PURPOSE: We aimed to assess the severity of coronavirus disease 2019 (COVID-19) pneumonia on computed tomography (CT) using quantitative (QCT) and semiquantitative (SCT) assessments and compare with the clinical findings. METHODS: Two observers independently examined the CT images of COVID-19 patients, and the SCT severity score was calculated. The SCT score was calculated as the sum of values ranging from 0 to 4, according to the volumetric rate of involvement for each lung lobe. In quantitative assessment, total lung volume (TLV) was automatically calculated from CT density values between -200 and -950 HU. Besides, healthy lung volume (HLV) was calculated from voxels between -800 and -950 HU. The QCT score was calculated with the following formula: (TLV - HLV / TLV) ×100. All patients were clinically divided into four groups: mild, common, severe, and critical. Interobserver agreement for SCT assessment was investigated using the Cohen's Kappa statistics (κ). Pearson's correlation coefficient was used for the relationship between continuous data. The diagnostic accuracy of SCT and QCT in the differentiation of clinically limited (mild, common) and extensive (severe, critical) disease was investigated using ROC analysis. RESULTS: Seventy-six patients with a diagnosis of COVID-19 were included. There was good agreement between the two observers in the SCT evaluation of pulmonary disease severity (κ = 0.796; 95% CI, 0.751-0.841). A significant correlation was found between QCT and SCT scores (p < 0.001, r = 0.661). Both QCT and SCT scores showed a significant correlation with clinical severity score (p < 0.001, r = 0.620 and p = 0.004, r = 0.529, respectively). The ROC analysis revealed the AUC of QCT and SCT for differentiation of limited and extensive disease as 0.873 (95% CI, 0.774-0.972) and 0.816 (95% CI, 0.673-0.959), respectively. CONCLUSION: The QCT assessment is an objective method in the evaluation of COVID-19 severity and is more successful than semiquantitative CT assessment to discriminate extensive from limited disease.
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COVID-19/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Tórax/diagnóstico por imagem , Adulto JovemRESUMO
The fatality rate of Crimean-Congo haemorrhagic fever (CCHF) disease has been reported as 5.4-80%. In this prospective study our aim was to evaluate the clinical and laboratory predictors of fatality in patients with CCHF. Among probable CCHF patients admitted to our clinic between 2005 and 2008, patients with positive IgM antibodies and/or polymerase chain reaction for CCHF virus were included in the study. To determine the predictors of fatality, we compared epidemiological, clinical and laboratory findings of the fatal cases with survivors. Ninety-three confirmed CCHF patients were included in the study; 56 (60.2%) of them were female. Mean patient age was 48.4+/-17.7 y and mean hospital stay was 7.9+/-3.0 days. Five patients died (5.4%). The rates of haemorrhage, diarrhoea and confusion were higher in fatal cases compared with non-fatal cases (p<0.05). Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, lactate dehydrogenase (LDH), and C-reactive protein levels were higher in fatal cases; the international normalized ratio (INR) and activated partial thromboplastin time (aPTT) were longer and mean platelet counts were lower (p<0.05). By multivariate analysis, diarrhoea, melena, haematemesis, haematuria, elevated ALT and LDH, and prolongation of aPTT were independent clinical and laboratory predictors associated with fatality. We suggest that for patients who have diarrhoea, melena, haematemesis, haematuria, elevated AST and LDH, and a prolonged aPTT, physicians should be aware of the high fatality risk.
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Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diarreia , Feminino , Hemorragia , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Febre Hemorrágica da Crimeia/sangue , Febre Hemorrágica da Crimeia/diagnóstico , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/mortalidade , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores de Risco , Estatísticas não Paramétricas , Turquia/epidemiologiaRESUMO
The impacts of nanoparticles (NPs) on wastewater treatment have become a great concern because of their widespread applications. Although the acute responses of anammox bacteria to NPs have enhanced the knowledge about the potential risks of them, deep understanding of the cumulative impacts of NPs must be assessed. The purpose of this research was therefore to further extend the current knowledge by evaluating both acute and long-term effects of Zinc oxide (ZnO) NPs on Anammox process based on nitrogen removal performance, self-recovery ability and microbial community structure. The acute exposure tests indicated that, the median inhibition concentration (IC50) of ZnO NPs on Anammox process was 84.7 mg/L (54.82 mg ZnO NPs/g VSS). Acute exposure of 200 mg/L ZnO NPs (117.54 mg Zn/g VSS) caused 80% inhibition in batch assays while the long-term inhibition dosage was 100 mg/L ZnO NPs (187.50 mg ZnO NPs/g VSS) corresponding to 1022 mg/L total Zn (1916.27 mg Zn/g VSS) in the reactor due to the accumulation of NPs. Total, soluble and biomass-associated Zn concentrations were measured throughout the long-term exposure to observe the behavior of ZnO NPs in the reactor. Total Zn in the reactor was cumulatively increased and mostly originated from biomass-associated Zn. Following the long-term inhibition tests, self-recovery of Anammox process within 120 days demonstrated that, the ZnO NPs inhibition is reversible for the applied dose. Furthermore, next generation sequencing results indicated a symbiotic relationship between the microbial groups in the anammox bioreactor while relative abundance of Candidatus (Ca.) Brocadiaceae family showed a decrease parallel to the deterioration in nitrogen removal performance of bioreactor. At the end of the long-term exposure studies, 48.76% decline on anammox quantity was detected.
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Nanopartículas Metálicas/química , Reatores Biológicos , Nitrogênio , Águas Residuárias , Óxido de ZincoRESUMO
Orthotopic liver transplantation is a life-saving procedure for patients with end-stage liver failure. However, Acinetobacter baumannii infections and acute rejection are important causes of morbidity and mortality following transplants. Here we present a case report of a cadaveric donor liver transplantation with infectious complications detected after transplantation. The patient was a 64-year-old female. Because of non-alcoholic steatohepatitis due to hepatic insufficiency (model for end-stage liver disease (MELD): 12; Child-Pugh: 9B), liver transplantation from a cadaveric donor was performed. Following the transplantation, the patient developed a blood stream infection, urinary tract infection (UTI) and postoperative wound infection from biliary leakage. A. baumannii was isolated from blood, urine and wound cultures. Imipenem (4×500 mg), tigecycline (2×50 mg) and phosphomycin (4×4 g) were administered intravenously (IV). On the 14th day of treatment, the bile fistula closed and there was no bacterial growth in blood and urine cultures. The patient was discharged with full recovery. The duration of a transplant patient's hospital stay, intensive care unit stay, invasive interventions, blood transfusions and immunosuppressive treatments cause an increased risk of extensively drug-resistant (XDR) A. baumannii infections, and a high mortality rate is seen despite antibiotic treatment. Phosphomycin, used in combination therapy, may be an alternative in the treatment of XDR pathogens in organ transplant patients, due to its low side effect profile and lack of interaction with immunosuppressives.
Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Transplante de Fígado/efeitos adversos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecções por Acinetobacter/diagnóstico , Acinetobacter baumannii/efeitos dos fármacos , Cadáver , Feminino , Humanos , Pessoa de Meia-Idade , Sepse/tratamento farmacológico , Sepse/etiologia , Sepse/microbiologia , Infecção da Ferida Cirúrgica/microbiologia , Resultado do TratamentoRESUMO
INTRODUCTION: Current studies suggest that tears and conjunctival secretions may be an important transmission route in coronavirus disease 2019 (COVID-19). The study aims to evaluate the presence of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) virus in tears and conjunctival secretion of patients with COVID-19. METHODOLOGY: A prospective interventional case series study was performed, and 32 patients with COVID-19 were selected at the Pamukkale University Hospital from 15 to 22 May 2020. The tear and conjunctival samples were collected by a conjunctival swab. Each specimen was sent to the laboratory for reverse transcription-polymerase chain reaction (RT-PCR) analyses. To avoid cross-infection, gloves and personal protective equipment were changed after collecting each sample. RESULTS: 32 patients (18 male, 14 female) with Covid-19 were included in this cross-sectional study. The average age of the patients was 52.81 ± 16.76 years. By the time of the first collection of conjunctival-tear samples, the mean time of the onset of complaints was 6.84 ± 6.81 (1-35) days. Tear-conjunctival samples from 5 patients (16%) without conjunctivitis yielded positive PCR results, 3 of whom had positive and 2 negative nasopharyngeal PCR results. CONCLUSIONS: Five of 32 patients (16 %) without conjunctivitis or any eye symptoms had viral RNA in their tear-conjunctival samples. The possibility of transmission via tears and conjunctival secretions should be recognized even in the absence of conjunctivitis or other ocular manifestations.