Aims
The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO ...aetiology and factors influencing the final diagnosis of FUO in Turkey.
Methods
A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated.
Results
The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult‐onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71).
Conclusions
Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state‐of‐the‐art technology in healthcare services.
We aimed to investigate the effects of colchicine, an important anti-inflammatory agent, on cognitive functions in a geriatric population diagnosed with gout or osteoarthritis by comparing it to ...non-colchicine users.
138 geriatric patients (67 colchicine users and 71 non-users) were enrolled. Within comprehensive geriatric assessment (CGA), cognitive status assessment via Mini-Mental State Examination test (MMSE), Quick Mild Cognitive Impairment Screening test (Qmci), clock drowning test (CDT), and digit span tests were performed.
Median age was 68 (65-72), and there were 82 female (59.4%) patients. The scores of CDT, Backward Digit Span Test, MMSE-Total, MMSE-Attention, MMSE-Motor Function, Qmci-Total Score, Qmci-Clock drawing, and Qmci-Logical Memory were significantly higher in the colchicine user group (p < .005), showing better cognitive function. Adjusted model analysis showed that colchicine usage is independently correlated with higher Qmci-Total Score and Qmci-Logical Memory Score (For Qmci total score β = 7.87 95%CI = 5.48-10.27, p = <0.0001, and for Qmci Logical memory score β = 3.52, 95%CI = 2.12-4.91, p = <0.0001).
To the best of our knowledge, this is the first study revealing that colchicine usage is associated with better cognitive performance in older adults. Further investigations with a prospective, larger-sampled and randomized design are needed to show the causal relationship between colchicine and cognition.
The objective of this study is to investigate a possible correlation between anxiety status and anti-Mullerian hormone (AMH) levels among healthcare professionals who provide medical care directly to ...COVID-19-positive patients during the recent pandemic. Fifty-two healthcare professionals (nurses, midwives, and residents) who provide medical care directly to COVID-19-positive patients in inpatient clinics or intensive care units were enrolled in this study. Serum AMH levels were analyzed to reflect ovarian reserve. The Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI-S and STAI-T, respectively) were completed by participants to assess their anxiety status. A linear regression model with participant age as the constant variable was applied to analyze the relationship between inventory scale scores and AMH levels. P-values less than 0.05 were considered statistically significant. The mean AMH value was significantly lower for the participants in the moderate/severe anxiety group compared to the minimal/mild anxiety group (p = 0.007). A linear regression analysis revealed a significant negative correlation between AMH levels and both BAI (B = -0.030, standard error = 0.010, p = 0.004) and STAI-S and STAI-T scores when age was controlled (both p = 0.003). The severity of anxiety experienced during the recent COVID-19 pandemic among healthcare professionals, who provide medical care directly to COVID-19-positive patients, is found to be related to low AMH levels.
•Pregnant women with COVID19 had higher serum midkine level.•Serum midkine level could be a predictor of COVID-19 disease severity.•Midkine level correlated with length of hospitalization and O2 ...saturation.
New biomarkers for diagnosis and monitoring the COVID-19 disease are the most important topics to be studied recently. We aimed to investigate the association between midkine levels and disease severity in pregnant women with COVID-19.
Totally 186 pregnant women were participated in this study. 96 of them were healthy pregnant women, 90 of them were pregnant women with COVID19. Pregnant women were evaluated according to their trimesters. Serum midkine level, biochemical profile clinical and disease severity outcomes of pregnant women were obtained.
Our results showed that pregnant women with COVID19 have significantly increased serum midkine level compared to healthy pregnant women (1.801 ± 0.977 vs 0.815 ± 0.294 ng/dL). According to the data among each trimester, it was shown that there were significant increase in serum midkine level during all pregnancy trimesters (1st trimester Control Group: 0.714 ± 0.148, COVID-19 group 1.623 ± 0.824, p < 0.0001; 2nd trimester Control Group: 0.731 ± 0.261, COVID-19 group 2.059 ± 1.146, p < 0.0001; 3rd trimester Control Group: 1.0 ± 0.35, COVID-19 group 1.723 ± 0.907, p = 0.001). Serum midkine levels were significantly different between disease severity subgroups of pregnant women with COVID19; moderate and severe/critic groups had significantly higher serum midkine level than mild group. There was also significant correlation between serum midkine level and severity status (p:0.0001, r: 0.468). The most striking results of serum midkine levels were corelation between length of hospitalization (p: 0.01, r: 0.430) and O2 saturation (p < 0.0001, r: −0.521). ROC curve analysis showed that serum midkine level might be a tool for predicting COVID-19 in pregnant women with COVID-19 (AUC: 0.912, 95% CI: 0.871, 0.952, p < 0.0001)
Our data showed that there is an obvious relation between COVID19 progression and serum midkine level for the first time which might be used for monitoring the disease process.
A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ...ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day. Two weeks after the discharge the patient was admitted to emergency department with severe left flank pain, palpitation and malaise. KUB (kidney-ureter-bladder) radiography showed double-J stent (DJS) to be repositioned to the proximal ureter. Patient was evaluated with contrast enhanced CT which revealed an 8cm intraparenchymal hematoma/abscess in the middle part of the kidney. A percutaneous drainage catheter was inserted into the collection. The percutaneous drainage catheter and the DJS were removed at the 10th day of second hospitalization. RIRS surgery is an effective and feasible choice for renal stones with high success and acceptable complication rates. However, clinician should be alert to possible complications.
INTRODUCTION: We aimed to evaluate the etiologic factors and pregnancy outcomes of pregnant women who applied to our antenatal outpatient clinics with the complaint of pruritus. METHODS: A ...retrospective study was conducted to examine the age, gestational weeks, gravidity, parity, comorbidities, laboratory test results and obstetric outcomes of pregnant women who applied with the complaint of pruritus to the antenatal follow-up outpatient clinics of Ankara City Hospital between 01.01.2020 and 31.12.2020. RESULTS: Medical records of 223 pregnant women who applied to our antenatal outpatient clinic with pruritus were evaluated, and the 181 pregnant with complete accessible data were enrolled in this study. The most common clinical diagnosis was pregnancy-specific dermatoses with a rate of 47.51% (n=86), and a specific diagnosis could not be determined in 80 pregnant women (44.19 %). Intrahepatic cholestasis (IHC) was found to be the most frequent diagnosis among the pregnancy-specific dermatoses with a percent of 25.41 (n=46). The incidence of IHC among specific dermatoses diagnosed ≥ 28 weeks of pregnancy was 30.76 %, and the most common dermatosis < 28 weeks was the atopic eruption of pregnancy (36.84 %). DISCUSSION AND CONCLUSION: Pruritus is a common condition in pregnancy; considering the frequency, especially in the third trimester, IHC should be kept in mind in the differential diagnosis to prevent maternal-fetal morbidity and mortality.
We consider the low scale implications in the U(1)′ extended minimal supersymmetric Standard Model (UMSSM). We restrict the parameter space such that the lightest supersymmetric particle (LSP) is ...always the lightest neutralino. In addition, we impose quasi-Yukawa unification (QYU) at the grand unification scale (MGUT). QYU strictly requires the ratios among the Yukawa couplings as yt/yb∼1.2, yτ/yb∼1.4, and yt/yτ∼0.8. We find that the need for fine-tuning over the fundamental parameter space of QYU is in the acceptable range (ΔEW≤103), even if the universal boundary conditions are imposed at MGUT, in contrast to CMSSM and nonuniversal Higgs masses. The UMSSM with universal boundary conditions yields heavy stops (mt˜≳2.5 TeV), gluinos (mg˜≳2 TeV), and squarks from the first two families (mq˜≳4 TeV). Similarly, the stau mass is bounded from below at about 1.5 TeV. Despite this heavy spectrum, we find ΔEW≳300, which is much lower than that needed for the minimal supersymmetric models. In addition, the UMSSM yields a relatively small μ term, and the LSP neutralino is mostly formed by the Higgsinos of mass ≳700 GeV. We also obtain bino-like dark matter of mass about 400 GeV. The wino is usually found to be heavier than Higgsinos and binos, but there is a small region where μ∼M1∼M2∼1 TeV. We also identify a chargino-neutralino coannihilation channel and A-resonance solutions which reduce the relic abundance of LSP neutralinos down to the ranges compatible with the current WMAP and Planck measurements.
Objective: Substance use is a gradually increasing public health problem. Viruses such as hepatitis B, hepatitis C, and HIV can be transmitted with intravenous substance use and cause significant ...morbidity and mortality. Therefore, we aimed to evaluate the hepatitis B, hepatitis C, HIV, and syphilis test results of patients followed at the Şanlıurfa Alcohol and Drug Addiction Research Treatment and Training Center (AMATEM) clinic.
Methods: The age, gender, background, information about type of substance addiction of the patients and HBsAg, anti-HBs, anti-HCV, anti-HIV, and venereal disease research laboratory (VDRL) test results were evaluated.
Results: A total of 427 patients over 18 who were followed at the AMATEM clinic between 2021 and 2022 were included in the study. Of these, 408 (95.6%) were male, and 19 (4.4%) were female. The mean age of the participants was 27.03±5.5 years. Three hundred fifteen (73.8%) patients had intravenous substance use, and all these patients (100%) used opioids. HBsAg positivity was detected in 3 (0.71%), and Anti-HCV positivity was detected in 52 (12%) patients. While only 20 (38.46%) of these patients had applied to the relevant clinics for further testing and treatment, HCV-RNA positivity was detected in 12 (60%) of the patients. In addition, the frequency of genotype 3 was higher in HCV RNA-positive patients (66.67%).
Conclusion: Opioid use was at the forefront both in the whole patient population and in patients with anti-HCV positivity. Although anti-HCV positivity was detected at a high rate compared to the general population, only one out of every three patients had applied to the relevant clinics for further testing and treatment. Thanks to the new treatment options Hepatitis C is a curable disease. Screening programs are extremely important to ensure both personal and community viral eradication by providing patients with suitable treatments.
Food spoilage results in food waste and food-borne diseases. Yet, standard laboratory tests to determine spoilage (mainly volatile biogenic amines) are not performed regularly by supply chain ...personnel or end customers. Here we developed a poly(styrene-co-maleic anhydride)-based, miniature (2 × 2 cm
) sensor for on-demand spoilage analysis via mobile phones. To demonstrate a real-life application, the wireless sensor was embedded into packaged chicken and beef; consecutive readings from meat samples using the sensor under various storage conditions enabled the monitoring of spoilage. While samples stored at room temperature showed an almost 700% change in sensor response on the third day, those stored in the freezer resulted in an insignificant change in sensor output. The proposed low-cost, miniature wireless sensor nodes can be integrated into packaged foods, helping consumers and suppliers detect spoilage of protein-rich foods on demand, and ultimately preventing food waste and food-borne diseases.
Objective: The aim of this study was to evaluate histopathological, functional and bone densitometry examinations of the beneficial effects of dexpanthenol (DEX) on nerve regeneration in a rat model ...of peripheral nerve crush injury.
Methods: Thirty adult Sprague-Dawley rats were divided equally into three groups. A crush injury was simulated in all rats by clamping the right sciatic nerve for one minute. In group 1, one day before the surgical procedure, 500 mg/kg DEX administered via intraperitoneally (ip) was initiated and continued three times in a week during the experiment period as 28 days. In group 2, rats received a dose of 10 mg/kg DEX to investigate possible effects of DEX alone. Group 3 served as the control (sciatic nerve injury) and was not given any drugs.
Results: Performance was significantly lower in group 3 compared to the drug treatment groups during the rotarod test (30 rpm and 40 rpm) (p < 0.05). After a while, the rats which were able to remain on the rod was significantly lower in group 3 during the acceleration test (p < 0.05). Hot plate latency test results in group 3 were significantly lower when compared to the other groups (p < 0.05).
Conclusion: DEX appears to be useful as a supportive clinical agent for the treatment of pain and nerve damage.
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