Seroprevalence of hepatitis E virus among primary school children

Objectives: To investigate the seroprevalence of anti-hepatitis E virus antibody among primary school children in the two different areas of Denizli, Turkey. Methodology: Anti-HEV antibodies were investigated in 185 primary school children (91 from rural areas and 94 from urban areas of Denizli). The children were divided into two age groups as seven-year old group and fourteen-year old group. Samples were tested for anti-HEV Ab by an enzyme-linked immunoassay. Results: A total of 23 primary school children were anti-HEV Ab positive, giving a prevalence of 12.4%. The seroprevalence rate was 13.1% in rural areas and 11.7% in urban areas. The difference in the seropositive rates was not statistically significant (p > 0.05). Among 185 primary school children, Anti-HEV antibodies were positive 17 (18.1%) in seven-year old group, and 6 (6.6%) in fourteen-year old group. The difference in the seropositive rates was statistically significant (p < 0.05). Conclusions: There was no association between the anti-HEV Ab and gender, socioeconomic level, parental educational level, rural or urban areas. Anti-HEV Ab seroprevalence was higher in seven-year old children than fourteen-year old children

Heart-Type Fatty Acid Binding Protein (H-FABP): Relationship with arterial ıntima-media thickness and role as diagnostic marker for atherosclerosis in patients with ımpaired glucose metabolism

<p>Abstract</p> <p>Background</p> <p>Heart type fatty acid binding protein (H-FABP) has been closely associated with acute coronary syndrome, cardiac abnormalities, stroke, and obstructive sleep disorder in previous studies. The aim of this study was to evaluate and compare the serum H-FABP levels and carotid artery intima-media thickness (CIMT) between patients with prediabetes and control subjects.</p> <p>Research design and methods</p> <p>We measured serum H-FABP levels in 58 prediabetic patients, 29 with impaired fasting glucose (IFG) and 29 with impaired glucose tolerance (IGT) and 28 age-, sex- and body mass index-matched control subjects using a sandwich enzyme-linked immunosorbent assay (ELISA), and in order to measure CIMT, all participants underwent high-resolution B-mode ultrasonography.</p> <p>Results</p> <p>Serum H-FABP levels were significantly elevated in pre-diabetic patients when compared with that of control subjects (IFG: 32.5 ± 34.2 ng/dL, IGT: 45.4 ± 45.8 ng/dL, control: 16.8 ± 14.9 ng/dL; p = 0.011). The difference in means of H-FABP levels between patients with IGT or IFG and control subjects was significant (p = 0.010 and p = 0.009, respectively). CIMT was higher in the pre-diabetic groups compared with the control group (IFG: 0.6 ± 0.1, IGT: 0.6 ± 0.1, control: 0.5 ± 0.1; p < 0.001), and H-FABP level was positively correlated with CIMT (p < 0.001, rho = 0.626).</p> <p>Conclusion</p> <p>Our results indicate that patients with pre-diabetes are at increased risk for cardiovascular disease. In addition, serum H-FABP levels could represent a useful marker for myocardial performance in patients with IFG and IGT.</p

Current barriers and recommendations on the diagnosis of transthyretin amyloid cardiomyopathy: a Delphi study

ObjectivesThis study has been conducted to investigate the non-invasive diagnostic journey of patients with a transthyretin amyloid cardiomyopathy (aTTR-CM) in Turkey, identify the challenges and uncertainties encountered on the path to diagnosis from the perspectives of expert physicians, and develop recommendations that can be applied in such cases.MethodsThis study employed a three-round modified Delphi method and included 10 cardiologists and five nuclear medicine specialists. Two hematologists also shared their expert opinions on the survey results related to hematological tests during a final face-to-face discussion. A consensus was reached when 80% or more of the panel members marked the “agree/strongly agree” or “disagree/strongly disagree” option.ResultsThe panelists unanimously agreed that the aTTR-CM diagnosis could be established through scintigraphy (using either 99mTc-PYP, 99mTc-DPD, or 99mTc-HMPD) in a patient with suspected cardiac amyloidosis (CA) without a further investigation if AL amyloidosis is ruled out (by sFLC, SPIE and UPIE). In addition, scintigraphy imaging performed by SPECT or SPECT-CT should reveal a myocardial uptake of Grade ≥2 with a heart-to-contralateral (H/CL) ratio of ≥1.5. The cardiology panelists recommended using cardiovascular magnetic resonance (CMR) and a detailed echocardiographic scoring as a last resort before considering an endomyocardial biopsy in patients with suspected CA whose scintigraphy results were discordant/inconclusive or negative but still carried a high clinical suspicion of aTTR-CM.ConclusionThe diagnostic approach for aTTR-CM should be customized based on the availability of diagnostic tools/methods in each expert clinic to achieve a timely and definitive diagnosis

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

The effects of intravenous and transdermal nitroglycerin on blood rheology in patients with acute myocardial ischemia

Bu çalışmada akut miyokard infarktüsü (AMI) ve kararsız anjina pektorisi (KAP) olan 50 hastada İntravenöz (ÎVNTG) ve transdermal nitrogliserinin (TNTG) kan reolojisine etkileri araştırıldı. Yirmibeş hastaya günde 2 kez 10 mg TNTG, diğer 25 hastaya da 15/ug/dk İVNTG verildi. Yaş ortalaması TNTG verilen grupta 55+10 (33-75), ÎVNTG grupta ise 52+10 (34-78) idi (p>0.05). Tedavi verilmeden önce ve tedaviye başlandıktan 24 saat sonra, hastaların hemoglobin (Hb) ve homatokrit (Hct) düzeyleri, trombosit sayıları, serum sodyum (Na), total protein ve albumin değerleri ölçüldü. Transdermal NTG verilen grupta tedavi öncesi ve 24 saat sonrası Hb, Hct ve serum albumin değerleri sırasıyla 13.9+1.9-13.4+1.8 g/dl, 42.0+5.5-40.2+6.0 (%) ve 4.1+0.4-3.9+0.2 (g/dl) bulundu (p<0.05). İVNTG verilen grupta ise tedavi öncesi ve sonrası Hb, Hct, trombosit, serum Na, protein ve albumin değerleri sırasıyla 14.4+1.5-13.8+1.9 (g/dl), 43.9+4.4-41.6+5.2 (%), 229.1+65.4-2107+63.4 (bin/mm") 144.9+4.4-141+3.3 (mEq/lt), 7.4+0.6-7.1+0.7 (g/dl) ve 4.0+0.4-3.7+0.5 (g/dl) (p<0.02) idi. Transdermal NTG verilen grupta trombosit, serum Na ve protein düzeylerinde azalma gözlen-mesine rağmen bu değişiklik istatistiksel olarak anlamlı değildi. Sonuçta İVNTG ve TNTG 'in kan Hb, Hct ve serum albumin düzeylerinde düşmeye neden olarak kan viskozitesini azalttığı, NTG 'nin koroner dilatasyon yapıcı etkilerinin yanında hemodilüsyon yapıcı etkisinin de akut miyokard iskemisinde ek bir fayda sağlayabileceği kanısına varıldı.The effects of intravenous (IVNTG) and transdermal nitroglycerin (TNTG) on blood rheology were investigated in 50 consecutive patients with acute chest pain due to unstable angina (n=25) and acute myocardial infarction (n=25). NTG was given intravenously in a dose 15 meg/sec for 24 hours in 25 patients, aged 34-75 (55+]0), within 24 hours after the onset of chest pain. Haemoglobin, hematocrit, number of platelets, serum sodium, total protein and albumin levels decreased significantly after administration of IVNTG. The values were 14.4+1.5 vs. 13.8+1.9 (g/dl), 43.9+4.4 vs. 41.6+5.2(%), 229.1+65.4 vs. 2107+63.4 (bin/mm-) 144.9±4.4 vs. 141+3.3 (mEq/lt), 7.4+0.6 vs. 7.1+0.7 (g/dl) vs. 4.0+0.4 vs. 3.7+0.5 (g/dl) respectively (<0.02). Only decrease in haemoglobin, he-matocrit and serum albumin values as 13.9±1.9vs. 13.4+1.8 g/dl, 42.0+5.5 vs. 40.2+6.0 (%) ve4.1+0.4vs. 3.9+0.2 (g/dl) reachedthe significant levels (<0.05). Our study suggests that decrease in haemoglobin, hematocrit and serum albumin levels after IVNTG and TNTG are probably due to hemodilution which might cause a decrease in blood viscosity. Thus, this effect of nitroglycerin may be additionally beneficial in the treatment of acute myocardial ischemia

Bilateral acute iris transillumination following a fumigation therapy: a village-based traditional method for the treatment of ophthalmomyiasis

Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber and atonic pupilla. We report herein a 50-year-old female who presented with bilateral ocular pain, severe photophobia and red eyes. One month ago, a fly hit her eye, and she instantly complained of a discomfort and sensation of a foreign body in both eyes. She used a fumigation therapy, a traditional method for the treatment of ophthalmomyiasis. During follow-up examinations, intraocular pressures increased over 40 mmHg bilaterally despite maximal medical therapy, which necessitated trabeculectomy surgery with mitomycin. This is a typical BAIT case with no antecedent fluoroquinolone use or viral disease, but a fumigation therapy. There might be a possible relationship between BAIT and traditional fumigation therapy or this association might be coincidental, both of which need further evaluation

Multiple sub-epidermal calcified nodule mimicking eruptive xanthoma: A case report and review of the literature

Sub-epidermal calcified nodule (SCN) is an uncommon form of idiopathic calcinosis. It usually occurs in children, particularly in the head and neck region, presenting as a solitary, painless, yellow-white nodule with papillomatous features. These lesions occur twice as common in males compared with females. The pathogenesis is uncertain, but the clinical and histological features of this lesion are distinctive. We report a case of 22-year-old man with multiple nodules bilaterally located on the dorsum of hands simulating eruptive xanthoma. Histopathological examination of one of the excised lesion confirmed the diagnosis showing epidermal and sub-epidermal deposition of calcium. This paper presents a review of the literature and adds a new case of SCN

The clinical efficiency of acupuncture in preventing migraine attacks and its effect on serotonin levels

Objectives: This study aims to investigate the efficacy of acupuncture in preventing migraine attacks