Effetcs of platelet function on the haemorrhagic manifestations and mortality in Crimean-Congo haemorrhagic fever

Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease which can lead to life-threatening with haemorrhagic manifestations. We aimed here in this study was to evaluate the effect of the platelet count and volume-related indices, such as the mean platelet volume (MPV), platelet distribution width (PDW) which is a measure of platelet anisocytosis and plateletcrit, in the haemorrhagic manifestations and mortality seen in CCHF cases. We retrospectively examined data derived from 173 patients. The age, gender, alanine transaminase (ALT), aspartate transaminase (AST), platelet counts and MPV, PDW and PCT values upon admission (MPV1, PDW1 and PCT1) and those values measured at the time when the PLT was at the lowest level (MPV2, PDW2 and PCT2), haemorrhagic manifestations and the mortality status of patients diagnosed with CCHF were recorded. ALT and AST values were higher among the haemorrhagic patients when compared with the others (p<0.001), while platelet 1 (PLT1), platelet 2 (PLT2), plateletcrit 1 (PCT1), plateletcrit 2 (PCT2) and platelet distribution width 2 (PDW2) values were significantly lower (p=0.001, p<0.001, p=0.002, p<0.001 and p=0.003, respectively). A negative correlation was documented between haemorrhage and the PLT1, PLT2, PCT1, PCT2 and PDW2 (r=-0.255, r=-0.415, r=-0.241, r=-0.377, r=-0.223, respectively); however, there was a positive correlation between haemorrhage and mortality (r=0.34). This was the first study evaluating the platelet functions in CCHF, such as the PLT, PDW and PCT, in CCHF correlated with the mortality and haemorrhagic manifestations. The platelet functions contribute as much to the prediction of haemorrhage and mortality as the PLT. The present study suggests that the PCT and PDW values could be beneficial in anticipating the inclination toward haemorrhage and mortality. © 2018, EDIMES Edizioni Medico Scientifiche. All rights reserved

A Review of Architects' Corner Building Design Approaches

Köşenin tasarımı, mimari tasarım alanında önemli bir problem olarak yer almakta ve kent köşelerinin anlamsal olarak kentlinin sosyal yaşamındaki önemi vurgulanmaktadır. Bu çalışma, mimaride köşelerin anlamına ve mimarların köşe bina tasarımı yaklaşımlarına odaklanmaktadır. Bu amaç doğrultusunda mimarlara uygulanmak üzere sorgulama metni tasarlanmış ve veri analizi yöntemi olarak parametrik hipotez testleri içerisinde yer alan bağımsız örneklem t testi uygulanmıştır. T test grubunda veriler köşe parselde bina tasarlayanlar/tasarlamayanlar olmak üzere analiz edilmiş ve anlamlılık analizinde ölçüt olan, ″005″ değerine eşit veya küçük bir değer izlenmemiştir. Değerlendirme sonucunda köşe parselde bina tasarlayan ve tasarlamayan mimarlar arasında anlamlı bir farklılık görülmemiştir.In architectural design, designing a corner building is considered to be a major problem and the significance of the meaning of urban corners is emphasized. The aim of this study, focusing on the corner is to investigate the meanings attributed by architects to the design of a corner building. Within this aim, the methodology is adopted for the study, involving literature review, designing and the implementation of questionnaire. For the data analysis, the t-test, which shows whether any significant difference exists between two independent groups is used. In conclusion, no significant difference is found between the architects who had and had not designed corner buildings, based on their answers

Odnos krimsko-kongoanske hemoragijske groznice i klime: utječe li klima na broj ovih bolesnika?

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 under-taking necessary measures.Krimsko-kongoanska hemoragijska groznica (KKHG) je virusna zoonoza koju prenose krpelji. Dokazano je da klimatski čimbenici utječu na incidenciju zoonotskih bolesti. U ovom smo istraživanju ispitivali bolesnike endemske za područje KKHG te odnos broja bolesnika i klimatskih svojstava područja u kojem oni žive. U istraživanje je bilo uključeno 548 bolesnika s KKHG. Uz demografske i kliničke značajke bolesnika bilježili smo temperaturu, vlagu i količinu padalina u mjestu gdje su bolesnici živjeli u vrijeme prijma u bolnicu. Uz vrijednosti temperature, vlage i količine padalina u vrijeme prijma bolesnika u bolnicu, vrijednosti ovih parametara procijenjene su za jedan mjesec i tri mjeseca prije prijma u bolnicu. Tada smo ispitali odnos broja bolesnika i gore spomenutih vrijednosti. Pokazalo se da razina vlage u vrijeme prijma i jedan mjesec prije prijma u bolnicu, kao i količina padalina tri mjeseca prije prijma u bolnicu utječu na broj bolesnika primljenih u bolnicu zbog KKHG. U zaključku, čini se da klima utječe na broj bolesnika s KKHG. Vjerujemo da bi se broj bolesnika koji dolaze u bolnicu zbog KKHG mogao predvidjeti uzimajući u obzir klimatska svojstva u mjestima gdje je zabilježena KKHG, a time bi se isto tako mogle poduzeti odgovarajuće mjere

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

Infection prevention and control practice for Crimean-Congo hemorrhagic fever - A multicenter cross-sectional survey in Eurasia

<div><p>Background</p><p>Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers.</p><p>Aim</p><p>Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia.</p><p>Methods</p><p>A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016.</p><p>Results</p><p>Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23).</p><p>Conclusions</p><p>Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.</p></div

The effective management of the historic urban context : an assessment of local conservation practice

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Investigation of Rubella antibodies among women of childbearing age in Sanliurfa province: An evaluation of three years period

Amaç: Bu çalışmada, 01.01.2007-31.12.2009 tarihleri arasında Şanlıurfa Kadın Hastalıkları ve Doğum Hastanesi’ne başvuran risk grubunu oluşturan doğurganlık çağındaki kadınlarda rubella virüsüne karşı oluşan antikorların seroprevalansının araştırılması amaçlanmıştır. Gereç ve yöntem: Çeşitli şikayetlerle hastaneye başvuran doğurganlık çağındaki kadınlardan alınan serum örneklerinde kemilüminesans immüno assay ve ElectroChemi Luminescence yöntemi ile çalışılan toplam 13.037 rubella IgM ve 12134 rubella IgG antikor sonuçları retrospektif olarak incelenmiştir. Sonuçlar üretici firmanın önerileri doğrultusunda negatif, sınır değer ve pozitif olarak sınıflandırılmış ve beş farklı yaş grubuna ayrılarak değerlendirilmiştir. Bulgular: Çalışmaya dahil edilen yaşları 15-49 arasında değişen13.037 kadının yaş ortalaması 28.35±7.48 idi. Çalışılan serum örneklerinde, rubella Ig M antikorlarının negatiflik, pozitiflik, ve sınır değer oranları sırasıyla %98.1, %1.7 ve %0.2 olarak saptanmıştır. Rubella IgG pozitifliği %94.1 iken; negatiflik oranı %5.9 bulunmuştur. Rubella IgG pozitiflik oranı en yüksek 35-44 yaş grubunda bulundu ve diğer yaş grupları ile karşılaştırıldığında 49 yaş üstü grup dışında anlamlı şekilde yüksek olduğu saptandı (p<0.001). Rubella IgM pozitifliği ise sadece 221 hastada bulundu (%1.7), pozitiflik oranı en çok yine 35-44 yaş aralığında görülmüş ve 25-34 yaş grubu dışında bu yüksek oran istatistiksel olarak anlamlı bulundu. (p<0.001). Sonuç: Doğurganlık çağındaki kadınlarda yüksek oranda rubella seropozitifliği saptadığımız için Şanlıurfa ilinde kadınlarda rubella antikorlarını taramaya gerek olmadığı sonucuna varılabilir. Ancak gebelikte geçirilecek bir enfeksiyon varlığında yaşanacak sorunlar düşünüldüğünde çocukluk çağında aşılanmayan veya daha önce geçirmeyen kadınlara hamilelik öncesi tarama yapılarak aşı önerilebilir.Objectives: The aim of this study was to investigate seroprevalance of antibodies against rubella virus that may lead to congenital infection among women of fertility age as a risk group that referred to Şanlıurfa Women's Health and Maternity Hospital in the period between 01.01.2007 and 31.12.2009. Materials and methods: The results of 13.037 of rubella IgM and 12.134 of rubella IgG antibodies that investigated in the sera samples, by using the methods chemiluminescense immunoassay and electrochemiluminescence, obtained from the women in fertility age that referred to the hospital with various complaints. Results were evaluated by classifying in five age subgroups in terms of negative, border line and positive according to the manufacturer's description. Results: Totally, 13.037 women in the age range of 15-49 years (average age 28.35±7.48 years) were evaluated. Negative, positive and border line ratios of the rubella IgM antibodies were found as 98.1%, 1.7% and 0.2%, respectively. Rubella IgG seropositivity was 94.1% whereas its seronegativity rate was 5.9%. The highest rate of rubella IgG seropositivity was found in the 35-44 years age group. In comparison to the other age groups, this would be considered significantly high except up to 49 age group (p<0.001). Rubella IgG seropositivity was found only in 221 patients (1.7%). The highest seropositivity rate was found in the age range of 35-44, and this high rate was statically significant except that in the age group of 25-34 (p<0.001). Conclusion: Because of the rubella seropositivity was high in this province, it might be concluded that scanning of the antibodies to rubella in women living in Şanlıurfa was unnecessary. However, considering of the problems due to the infection during pregnancy, antibodies to rubella should be scanned in women that not vaccinated in the childhood age or previously not have the disease, and they should be offered the vaccination

Methylene-tetrahydrofolate reductase gene C677T and A1298C polymorphisms as a risk factor for Crimean-Congo hemorrhagic fever

Crimean-Congo hemorrhagic fever (CCHF) is a deadly viral disease. Methylene-tetrahydrofolate reductase (MTHFR) has an important role in folate metabolism, and also in the formation of new cells, DNA synthesis, repair and methylation. We aimed to examine the relationship between MTHFR gene C677T (Ala222Val, rs1801133) and A1298C (Glu429Ala, rs1801131) polymorphisms with CCHF in a Turkish population. Totally 273 participants were included in the current study. One hundred forty-one participants were CCHF patients and one hundred thirty-two participants were healthy controls. The polymerase chain reaction (PCR) and further restriction fragment length polymorphism (RFLP) assays were applied to determine the genotypes of MTHFR polymorphisms. We did not find any differences between the CCHF patients and healthy controls in terms of allele and genotype distributions of both the C677T and A1298C polymorphisms. After dividing the CCHF patients into different groups, we found that AC and AC + CC genotype frequencies of A1298C polymorphism were higher in Non-fatal patients compared to controls (p = 0.014 and p = 0.027, respectively). In composite genotype analysis between different groups, the frequency of CT-AA composite genotype, which is formed by C677T-A1298C polymorphisms, was found to be significantly higher in Mild CCHF patients compared to both Severe CCHF patients and controls (p = 0.036 and p = 0.008, respectively). In conclusion, in this study, we found a relationship between CCHF and MTHFR gene polymorphisms. Genotypes consisting C allele of A1298C polymorphism poses a risk for CCHF in Non-fatal group and CT-AA composite genotype of MTHFR gene C677T and A1298C polymorphisms showed a predisposition to Mild CCHF