The use of new oral anticoagulants in geriatric patients: A survey study for physicians

The use of new oral anticoagulants in geriatric patients: A survey study for physicians Introduction: The use of new oral anticoagulants (NOACs) for the treatment of thromboembolic diseases is becoming more widespread. The present study brings together the opinions and daily routine clinical practices of physicians regarding the use of NOACs in the geriatric age group for the treatment of venous thromboembolic diseases. Materials and Methods: The study accessed 274 physicians (197 attending, 70 resident and seven primary care physicians) with various specialties and academic positions through face-to-face interviews or e-mails, and asked them to complete a questionnaire form prepared for NOAC use on a voluntary basis between 1 May and 31 December 2019. Results: It was found that physicians preferred NOACs mostly for patients contraindicated for the regular use of low-molecular-weight heparins and warfarin (n: 264, 96%), and with an unbalanced INR level (n: 230, 87%). The use of NOACs was found to be higher in the geriatric age group than other anticoagulants due to the easy dose adjustment, the extended monitoring intervals and the low risk of bleeding. Among the physicians, neither the specialty nor a higher number of occupational working years affected the preference for NOACs or other anticoagulants. Conclusion: Our study has demonstrated that physicians consider NOACs to be a good treatment option in terms of efficacy and reliability for the treatment of thromboembolic diseases in the geriatric age group, who may have treatment compliance difficulties. It was found also that they plan treatment considering the benefit-to-harm ratio and the bleeding–ischemic event balance. © 2021 by Tuberculosis and Thorax

Hepatit B enfeksiyonu olan hastalarda yaşanılan zorlukların değerlendirilmesi

Objectives: Although stigma is well defined in people with a chronic disease or condition, it has not been studied much in individuals infected with hepatitis B virus (HBV). The study is one of the first descriptive individual studies conducted on this subject in our country. Our aim in this study was to evaluate the stigma experiences and concerns of individuals living with HBV, their sharing of their illness with the environment, and the state of being affected by their social relationships. Materials and Methods: Patients with hepatitis B surface antigen positivity who were admitted to the infectious diseases outpatient clinic were surveyed through face-to-face interviews. Epidemiological data, stigma experiences and anxiety states, people with whom they shared their illness, the reasons for not sharing, the impairment of social relations were questioned. Results: It was found that 19.5% of 390 individuals infected with HBV who participated in our study were "exposed" to stigma in various ways, and 27.4% were "worried" about experiencing this condition. In research, 19.9% of women, 41.4% of university graduates, and 34.8% of divorced or widowers were found to experience higher stigma (p=0.002, p=0.02 and p<0.001, respectively). It was determined that 56.7% of the participants did not share their illnesses, and this need increased with stigma experiences and anxiety. It was found that individuals mostly shared their disease status with their first-degree relatives (p<0.001). Conclusion: The fact that individuals infected with HBV experience different forms of stigma or experience anxiety suggests that there is a need to investigate these conditions and develop treatment interventions

Is liver biopsy necessary in patients with chronic hepatitis B with normal alanine aminotransferase level?

Objectives: If not treated early, morbidity and mortality will remain high in hepatitis B virus infection. In this study, it was aimed to analyze the liver biopsy results of patients with chronic hepatitis B with normal alanine aminotransferase (ALT) levels. Materials and Methods: The study was conducted retrospectively. The patients who were admitted in the infectious diseases and clinical microbiology outpatient clinic, had liver biopsy and received treatment between 01.09.2019 and 01.12.2019, were included. Results: A total of 169 patients were included in the study. Of the individuals, 95 (56.2%) were female, with a mean age of 42.4 +/- 11.15 years. The rates of having an histological activity index (HAI) score of 6/18 and above and a fibrosis stage of 2/6 or more (90%, 100%, respectively) in patients with ALT level above upper limit of normal (ULN) were higher than in patients with ALT level below ULN (63.6% and 79.1%, respectively) (p=0.001 and p=0.002, respectively). When 129 patients with ALT level below ULN were evaluated in subgroup analyses. HAI score was 6 or higher in 59 (58.4%) of the hepatitis B e antigen (HBeAg) negative patients, and fibrosis stage was 2 or higher in 76 (75.2%) patients. In patients with ALT below ULN and HBeAg positivity, the rates of HAI score of 6 and above and fibrosis stage of 2 and above were found to be statistically significantly higher than in HBeAg negative patients. Conclusion: Liver fibrosis and necroinflammation may develop in patients with normal ALT levels. In making the biopsy decision, ALT level should be considered together with other factors that may affect liver damage

The association between serum YKL-40 levels, mean platelet volume, and c-reactive protein in patients with cellulitis

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459; ERTURK, AYSE/0000-0001-6413-9165WOS: 000349843900013PubMed: 25657159Background: Lower limb cellulitis is an infectious disease that has serious complications unless it is treated. Objectives: in this pilot study, we evaluated whether levels of YKL-40, an acute-phase reactant, and mean platelet volume (MPV), which occurs secondary to inflammation in cellulitis, increase compared to healthy subjects. We also aimed to investigate the association between YKL-40 and MPV in the prognosis of the patients. Material and Methods: A total of 55 patients with cellulitis (23 men and 32 women) and a similar age group of 46 healthy individuals (22 men and 24 women) were included in the study. Cellulitis was diagnosed according to guideline. Serum YKL-40 levels, MPV, C-reactive protein (CRP), and other biochemical values of both groups were compared. Results: YKL-40 levels (52.2 +/- 34.5 ng/mL vs 34.6 +/- 18.0 ng/mL, P = 0.004), MPV (7.7 +/- 1.0 fL vs 6.9 +/- 0.7 fL, P < 0.001), and CRP (9.5 +/- 8.2 mg/dL vs 0.7 +/- 0.6 mg/dL, P < 0.001) were significantly higher in the patients with cellulitis than the control. the mean recovery time (RT) of the patients was 22.6 +/- 6.9 days. We found that YKL-40 (odds ratio [OR] 0.1, confidence interval [Cl] 0.028-0.191, P = 0.009) and MPV (OR 2.4, Cl 0.254-4.578, P = 0.029) have an independent association with RT. Conclusion: YKL-40 and MPV values were correlated with higher CRP in the cellulitis group than in controls. According to these results, increased YKL-40 and MPV levels might be a prognostic factor for cellulitis in patients

Distribution of Intestinal Parasites in Patients Admitted to the Government and University Hospitals in Rize Province

AimThe aim of this study was to retrospectively determine the prevalence of intestinal parasites in patients, whose examination material was sent to parasitology laboratory of two different hospitals in Rize province during the period of January 2012 to June 2013.Materials and MethodsStool samples were examined by direct macroscopy, native-lugol and trichrome staining methods for protozoan (cyst or trophozoites) and helminths (eggs or larvae). Cellophane preparations were examined for Enterobius vermicularis eggs.ResultsA total of 9.994 samples were investigated and parasites were identified from 240 samples (2.4%). Entamoeba coli (59.6%) was determined the most common parasite among the identified parasites and it was followed by E. vermicularis (12.5%), G. intestinalis (12.1%) and Entamoeba histolytica/dispar/dispar (9.6 %).ConclusionThere is less studies showing the prevalence of intestinal parasites in our region. It is compared to the work done in different places and times, parasites ration in our province was found very low (2.4%). The acceptance of the appropriate sample and the use of high sensitivity methods of investigation should be expanded for the effective recognition of parasitosis and their successful treatment. There is a slight improvement for socio-economic and environmental conditions in our country, but the parasitic infections are still a current and continous health problem in our society

Radyolojik Bulgularla Submandibular Bezde Dev Siyalolit: Olgu Sunumu

Siyalolit, bir tükürük bezi parankimi veya kanalı içerisinde, bir veya daha fazla sayıda, oval ya da yuvarlak formdaki kalsifik odak olarak tanımlanmaktadır. En sık submandibular tükürük bezinde ve 30-60 yaş aralığında görülmektedir. 46 yaşında erkek hasta dental tedavileri için İstanbul Üniversitesi Diş Hekimiği Fakültesi Ağız, Diş ve Çene Radyolojisi Kliniği’ne başvurmuştur. Panoramik radyografisinde rastlantısal olarak sağ mandibula angulus bölgesinde radyoopak bir oluşum görülmüştür. Klinik olarak ilgili bölgede herhangi bir semptom saptanamamıştır. Konik ışınlı bilgisayarlı tomografi incelemesinde sağ angulus bölgesinde, lingual alanda, iç yapısı mikst, hiperdens odak izlenmiş olup siyalolit olduğu tespit edilmiştir. Ultrasonografide ise submandibular tükürük bezi kanalı içerisinde olduğu belirlenmiştir. Herhangi bir semptom bulunmaması nedeniyle hastanın düazenli takibi sağlanmıştır. Klinik ve radyografik bulgular ile siyalolitin lokalizasyon ve ebatlarının belirlenmesi tedavi planlamasında önemlidir. Bu vaka sunumunda asemptomatik büyük boyutlu bir siyalolit olgusunun radyolojik bulgularını sunmak amaçlanmıştır.&nbsp;</p

In vitro antiviral evaluations of coldmix(R): An essential oil blend against SARS-CoV-2

Coldmix® is a commercially available Eucalyptus aetheroleum and, Abies aetheroleum blend for medicinal applications. In this present study, the in vitro antiviral potential of Coldmix®, and its major constituents 1,8-cineole and α-pinene were evaluated by using the in vitro ACE2 enzyme inhibition assay as well as the direct contact test against SARS-CoV-2. The observed ACE2 enzyme inhibitory activity of Coldmix®, 1,8-cineole, and α-pinene were 72%, 88%, and 80%, respectively; whereas in the direct contact test in the vapor phase, the destruction of the virus was 79.9% within 5 min and 93.2% in the 30th min, respectively. In a similar Coldmix® vapor phase setup using the in vitro cytotoxicity cell assay, E6 VERO healthy cells were experimentally not affected by toxicity. According to the promising initial antiviral results of Coldmix® and the individually tested constituents, detailed further in vivo evaluation using different virus classes is suggested

COVID-19 infection in pregnancy: A single-center experience in Rize in the Eastern Black Sea Region

Aim: In this study, it was aimed to share the clinical experiences of mothers and their babies (perinatal, natal) who encountered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Material and Methods: The study was carried out retrospectively, 62 pregnant individuals were diagnosed with the 2019 coronavirus disease (COVID-19). Demographic characteristics, clinical course, laboratory and radiological findings and clinical results of the baby were evaluated by examining electronic and file records. Results: The average age of the 62 pregnant women included in the study was 29.8 +/- 4.7 (19-42) years, and the average gestational week at the time of admission was 28.5 +/- 10.4 (5-40) weeks. More than half of the patients (80,6%) on admission were in their third trimester. The most common initial symptoms were cough (45.2%), myalgia (43.5%),) fever (21%). In total, 15 of the pregnant women had evidence of COVID-19 pneumonia in lung involvement. The PCR test results of all pregnant women were positive. There were three cases admitted to the intensive care unit, one of whom was due to gestational diabetes. No maternal mortality was recorded. One gestation ended in a miscarriage and two women gave birth prematurely. One stillbirth occurred at the 33h week of gestation. Among 22 neonates, two were admitted to the neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother- to- child transmission were not observed in newborns. Discussion: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild

Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection

Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19. Methods: The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II). Results: The mean age of the patients in Group-I was 49.718.0 years and the time between the onset of symptoms and admission to the hospital was 3.6 +/- 2.0 days; whereas the same values for the patients in Group-II were 58.1 +/- 19.9 and 5.3 +/- 4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-PCR positivity correlated positively with headache. Presence of CT findings was positively correlated with age, comorbidity, shortness of breath, fever, and the symptom duration. Conclusions: It should be noted that a negative result in the rtRT-PCR test does not rule out the possibility of COVID-19 diagnosis in patients whose symptom duration is longer than five days, who are elderly with comorbidities and in particular who present with fever and shortness of breath. In these patients, typical CT findings are diagnostic for COVID-19. A normal chest CT is no reason to loosen up measures of isolation in patients with newly beginning symptoms until the results are obtained from the PCR test

Production of Bovine Colostrum for Human Consumption to Improve Health

Colostrum contains all essential nutrients for the neonate during the first days of life, with impacts that continue far beyond these first days. Bovine colostrum has been used for human consumption due to the high concentrations of bioactive proteins, vitamins, minerals, growth factors, as well as free and conjugated oligosaccharides. Processes involved in the preparation of bovine colostrum for human consumption play a pivotal role in preserving and maintaining the activity of the bioactive molecules. As bovine colostrum is a multifunctional food that offers a myriad of benefits for human health, assessing the main processes used in preparing it with both advantages and disadvantages is a crucial point to discuss. We discuss major processes effects for colostrum production on the nutritional value, some advanced technologies to preserve processed bovine colostrum and the endproduct forms consumed by humans whether as dairy products or dietary supplements