Relationship between serum soluble endothelial protein C receptor level and COVID-19 findings

Coronavirus-related disease-2019 (COVID-19)-associated coagulopathy presents predominantly with thrombosis and leads to complications in close association with inflammatory process. Soluble endothelial protein C receptor (sEPCR), which is the soluble form of EPCR, reduces the anticoagulant and anti-inflammatory activity of activated protein C. The purpose of this study is to investigate the relationship between sEPCR and the laboratory parameters and thorax computed tomography (CT) findings in the course of COVID-19. Twenty-five laboratory-confirmed [reverse transcription-quantitative polimerase chain reaction (RT-qPCR) positive] and 24 clinically diagnosed (RT-qPCR negative) COVID-19 patients were enrolled in the study. Blood specimens were collected for sEPCR and haematological and biochemical parameter measurement. Thorax CT was performed to detect COVID-19 findings. These parameters from RT-qPCR positive and negative patients were then compared. Although there was no difference between the groups in terms of symptoms, the time between the onset of symptoms and the admission time was shorter in RT-qPCR positive group (P?=?0.000). sEPCR levels were significantly higher in the RT-qPCR positive group (P?=?0.011). Patients with ground-glass opacity and bilateral involvement on thorax CT have higher serum sEPCR levels (P?=?0.012 and 0.043, respectively). This study has shown for the first time that serum sEPCR levels, which is a member of coagulation cascade and has also been reported to be associated with inflammation, is higher in patients with positive RT-qPCR test and patients with GGO or bilateral involvement on thorax CT regardless of the PCR result. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved

Lyme Arthritis in Primary Care; Case Report

Primary health care is the closest point to the patient. The person who is ill or suspicious of his / her health goes to the family physician, the family health center or the closest health institution. The correct diagnosis and treatment at Primary health care center is of great importance in terms of the cost effectiveness and public health improvement. Lyme arthritis is one of the diseases caused by Borrelio Burgdorferi, spirochete passing through the bite of the hard ticks of Ixodes. Infections may involve the skin, central nervous system, heart, eye and other organs, while in most cases joints are the main site of involvement. A very small percentage of children presenting with arthritis complaints have Lyme arthritis. In Europe, the most common form of arthritis following bacterial infection in children and adolescents is Lyme arthritis. Frequently, joint swelling is accompanied by pain. In this case report, we present a patient with Lyme arthritis who complained of pain, swelling, and inability to walk