Crimean-Congo hemorrhagic fever

Crimean-Congo hemorrhagic fever (CCHF) is a fatal viral infection by Crimean-Congo hemorrhagic fever virus (CCHFV). Crimean-Congo hemorrhagic fever virus which is member of the Bunyaviridae family, Nairovirus genus is transmitted to humans through infected ticks. Crimean-Congo hemorrhagic fever was first recognized in the Crimean peninsula in 1944. The disease now occurs frequently throughout Asia, Africa, Eastern Europe and the Middle East. First cases have been reported in Turkey in 2002. 1820 cases and 92 deaths were reported until 2007. In our country, cases have especially been seen northern-east Anatolia. There has been a substantial increase in cases reports from the west part ofTurkey recently. HoweverAydın is nonendemic, first cases detected in 2006 and the number of cases have been reached 29.We aimed to inform on Crimean-Congo hemorrhagic fever and to analyze the clinical properties of detected casesKırım Kongo Kanamalı Ateşi (KKKA) KKKA virüsü (KKKAV) tarafından oluşturulan bazen ölümcül olabilen viral bir hastalıktır. KKKA virüsü (KKKAV) Bunyaviridae ailesinin Nairovirus cinsine ait olup keneler tarafından insanlara bulaştırılır. KKKA ilk kez 1944'de Kırım'da ortaya çıkmıştır. Günümüzde hastalık sıklıkla Asya, Afrika doğu Avrupa ve orta doğuda epidemiler yapmaktadır. Ülkemizde ilk olgular 2002 yılında rapor edilmiştir. Hasta sayısı, 2007 yılına kadar 1820'ye yaşamını yitirenlerin sayısı ise 92'ye ulaşmıştır. Hastalık ülkemizde özellikle kuzeydoğu Anadolu'da görülmekle birlikte son yıllarda batı illerinden de olgu bildirimlerinde artışlar söz konusudur. Aydın ili hastalık açısından nonendemik kabul edilmesine karsın ilk olgular 2006 yılında saptanmış ve görülen olgu sayısı 29'a ulaşmıştır. Bu yazıda KKKA ile ilgili genel bilgilerin verilmesi ile birlikte ilimizde görülen olguların klinik analizlerinin yapılması amaçlanmıştır

Angiographic assessment of atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy

Background: The aim of this study was to investigate atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy and compare them with patients with diabetic foot without charcot neuro-arthropathy. Methods: This retrospective study consists of 78 patients with diabetic foot who had lower extremity angiography with antegrade approach. All patients were classified into two groups; neuro ischemic wounds with charcot neuro-arthropathy (30/78) and without charcot neuro-arthropathy (48/78).Atherosclerotic load at the side of diabetic foot was determined by using the Bollinger angiogram scoring method. Comparison of atherosclerotic load between the two groups was performed. Results: The mean of total and infrapopliteal level angiogram scoring of all patients was 33.3 (standard deviation, sd:±17.2) and 29.3 (sd:±15.6), respectively. The mean of total and infrapopliteal level angiogram scoring of neuroischemic wounds with charcot neuro-arthropathy group was 18.1 (sd:±11.6) and 15.7 (sd:±10.4), respectively. The mean of total and infrapopliteal level angiogram scoring of neuroischemic wounds without charcot neuro-arthropathy group was 42.8 (sd:±12.7) and 37.7 (sd:±12.0), respectively. There was a statistically significant difference between the two groups of mean total and infrapopliteal angiogram scoring (p < 0.01). Conclusion: This angiographic study confirms that the atherosclerotic load in patients with diabetic foot and chronic charcot neuro-arthropathy is significantly less than in patients with neuroischemic diabetic foot wounds without chronic charcot neuro-arthropathy. Keywords: Angiography, Atherosclerosis, Charcot neuro-arthropathy, Diabetic foo