Systematic review of Lyme disease in Turkey

###EgeUn###A systematic review was conducted with the aim of describing the demographical data, features and outcomes of patients with Lyme disease (LD), reported from Turkey. Three international database (electronic PubMed, Web of Science and Scopus) and two national database (Ulakbim and Turkmedline) searches were performed using the following keywords (['Lyme' or 'Borrelia burgdorferi' or 'Borrelia' or 'Borreliosis'] and 'Turkey [ and/country]'). National Notifiable Diseases Surveillance System (NNNDS) of Centers for Disease Control and Prevention (CDC) criteria were used for classification. A PRISMA-based algorithm was used for systematic review. There were a total of 75 LD cases in 36 different reports. Studies related to LD are confined to case reports. We believe that LD is an important healthcare problem in Turkey and to our knowledge this is the first systematic review from this country

Crimean-Congo Hemorrhagic Fever: Retrospective Evaluation of Clinical Features and Laboratory Findings of 16 Cases

WOS:000609505000011Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease frequently transmitted by tick bite and accompanied by fever and bleeding. It may cause important public health problems. Besides clinical symptoms and epidemiological history, blood count and biochemical test results are the first clues for CCHF. in this study, we aimed to retrospectively evaluate 16 patients who were followed and treated due to CCHF in our hospital. Materials and Methods: The patients who were followed up and treated with CCHF between 2009-2019 in our clinic were evaluated retrospectively in terms of demographic characteristics, presenting complaints, presence of tick history, laboratory parameters, necessity of blood products replacement, hospitalization periods, ribavirin treatment and one-month survival. Results: Sixteen patients (ten females, six males, mean age 50.37 +/- 18.01 (min: 18-max: 79)] with the diagnosis of CCHF were included into the study. Presenting complaints were fever (16/16, 100%), fatigue (16/16, 100%), bleeding (9/16, 56.2%), petechial rash (7/16, 43.7%). nausea and vomiting (6/16, 37.5%). There was a history of tick contact in 14 cases (87.5%) but not in two cases. Supportive treatment was applied to all cases, and droplet and contact isolation were applied. Blood product replacement was performed in five patients (31.2%), and ribavirin was administered in nine patients (56.2%). Mortality rate was 6.3% (1/16). Conclusion: Crimean-Congo Hemorrhagic Fever is an endemic disease in our country. Especially in spring and summer months, patients with fever and cytopenia on hemogram should be questioned, and tick contact should be sought

The trivest in overreaching syndrome: Cardiac fatigue, muscular weakness, and vascular dysfunction

Although the underlying mechanisms responsible for cardiac dysfunction after prolonged exercise remains to be elucidated, it has reported cardiac deterioration following exhaustive exercise in the absence of underlying cardiovascular diseases, which has been attributed to cardiac fatigue. The objective of this study was to evaluate cardiac functions, exercise capacity, and flow-mediated dilatation in overreaching syndrome. We studied 13 male marathon runners who took part in a marathon. Cardiopulmonary exercise testing, transthoracic echocardiography and endothelium-dependent vasodilatation of the brachial artery were performed at before- and after-race. Peak oxygen consumption, left ventricular tissue Doppler imaging parameters and flow-mediated dilatation were decreased after-race values compared with before- race values. Overreaching syndrome could arise involves a physio-pathological trivest, cardio-vasculo-muscular axis, which include three vicious cycles. (C) 2007 Published by Elsevier Ireland Ltd

Ductal Adenocarcinoma of the Prostate With a Rare Clinical Presentation; Late Gastric Metastasis

A 67 year male had robotic prostatectomy whose pathology revealed mixed type prostate cancer composed of 55% ductal and 45% acinar components. The patient was then admitted to hospital with sudden health problems including ascites and serious vomiting attacks in the 46th month after prostatectomy and the PSA test was 4565 ng/mL. Gastroscopic biopsy was reported and proved immunhistochemically undifferentiated ductal prostate cancer metastasis. This is the first report of late gastric metastasis of ductal prostate cancer

Evaluation of Knowledge Level on Sexually Transmitted Diseases of Medical School Students Who Received HPV Vaccination

Introduction: Sexually transmitted diseases (STDs) can adversely affect sexual and reproductive health, especially starting from ado- lescence, in addition to the mortality and morbidity they cause. Of these, human papilloma virus (HPV) is of great importance because it is very common and can be prevented by vaccination. More widespread vaccination can be achieved by increasing awareness and knowledge, both in society and among physicians. In this study, it was aimed to evaluate the knowledge level of med school students, who had HPV vaccine, about sexually transmitted diseases.Materials and Methods: Socio-demographic characteristics and knowledge levels about sexually transmitted diseases were evaluated by filling out a questionnaire for med school students who were vaccinated in 2022 in our hospital. The dataset were put in Microsoft Office Excel program.Results: Total of 212 participants (169 females 79.7%; 43 males 20.3%, mean age 22.18 +/- 2.15 years) were included in the study. Participants stated that they heard about HPV vaccine; through classes 74.5% (n= 158), friends/family 43.4% (n= 92), and social media/TV 41% (n= 87). They defined the safest contraceptive method for STD as using condoms 68.9%, not having sexual intercourse 18.4%, and monogamy 12.7%. Question about causative relation with cancer development of listed agents answered as: HPV (99.1%), hepatitis B (70.8%), syphilis (6.6%), and Gonorrhea (3.8%).Conclusion: Increasing level of knowledge of young physicians and physician candidates about sexually transmitted diseases will certainly contribute to the awareness and vaccination of society. We believe that being aware of our shortcomings in this regard and reducing sexual health education to a much earlier age, will help solve this issue

Dost mu Düsman mi? COVID-19 Enfeksiyonu Tanili Hastalarda BCG Asisi ve Latent Tüberküloz Enfeksiyonu Etkisinin Degerlendirilmesi

While severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to spread rapidly worldwide, some issues such as the uncertainty of the disease progress, whether intensive care will be needed, and risk classification are still important for clinicians. It is notable that in countries where latent tuberculosis infection (LTBI) is common and participating in the national Bacillus Calmette-Guerin (BCG) vaccination program, the case-fatality rates are relatively low throughout the world. In this study, it was aimed to evaluate the effects of the BCG vaccine and LTBI status on the course of the disease in patients diagnosed with coronavirus-19 (COVID-19) infection and to compare the LTBI rate with people with and without COVID-19 infection. The patients diagnosed with COVID-19 infection who were hospitalized during a period of seven months between May 1st to December 1st, 2020 were investigated by the QuantiFERON-TB Gold Plus (QFT-Plus) test in the blood samples for the presence of LTBI. For the comparison of the patients diagnosed with COVID-19 and people without COVID-19 infections in terms of LTBI rate retrospectively; all consecutive patients who were sent blood samples to the mycobacteriology laboratory for the QFT-Plus test between January 2016 and December 2019 were included in the study. Demographic, clinical, radiological, laboratory, and follow-up data of the patients were obtained from the electronic patient file. A total of 170 patients (n= 9 8 male [57.6%], n= 72 female [42.3%], mean age= 53.5 +/- 15.8 years) were enrolled. Twenty-five patients' (25/170 [14.7%]) QFT-plus tests were positive. When the cases with positive QFT-Plus test (n= 25) and the cases with negative QFT-Plus test (n = 145) were compared in terms of disease severity respectively; it was determined that mild/moderate patients were 18/25 (72%) and 108/145 (74.5%), severe patients were 7/25 (28%) and 37/145 (25.5%) (p= 0.988). When these two groups were compared in terms of the clinical course respectively; the need for intensive care was 6/25 (24%) and 34/145 (23.4%) (p= 1.00), oxygen therapy requirement was 13/25 (52%) and 49/145 (33.8%) (p= 0.128), and death was 5/25 (20%) and 18/145 (12.4%) (p= 0.341). QFT-Plus positivity was 25/170 (14.7%) in patients diagnosed with COVID-19, while in control group it was 198/496 (39.9%) (OR= 0.259, 95% CI [0.164-0.411], p< 0.001). When the values were evaluated quantitatively, in the COVID-19 patient group, QFT-Plus T1/T2 (IU/ml) interferon (IFN)-. was 0.87 +/- 1.52/0.62 +/- 1.53, while in the control group it was 1.52 +/- 3.69/1.50 +/- 3.33 (p= 0.032, p= 0.04). There was no significant difference in the parameters investigated between 82 (48.2%) patients with BCG vaccine and those 88 (51.8%) without BCG vaccine. Although it was not statistically significant in our study, increased oxygen therapy requirement and higher mortality rates in the QFT-Plus positive group were remarkable. The detection of statistically significantly lower LTBI rates and T1-T2/IFN-. values in the COVID-19 group supported that SARS-CoV-2 infection may suppress lymphocyte functions in patients and IFN-. response. We believe that the results of our study are remarkably valuable, but more clinical studies are needed to elucidate the relationship between BCG vaccine, LTBI, and COVID-19 infection

COVID-19-related anxiety in people living with HIV: an online cross-sectional study

Tasbakan, meltem/0000-0002-4689-720XWOS:000600735500006PubMed: 32777899Background/aim: The emergence of the coronavirus disease 2019 (COVID-19) outbreak has had an enormous emotional impact on sonic vulnerable groups, such as people living with human immunodeficiency virus (HIV) (PLHIV). This study was planned with the aim of assessing the anxiety levels of PLHIV and the sources of their anxiety. Materials and methods: A web-based questionnaire was sent to PLHIV using the virtual snowball sampling method. The questionnaire included questions about sociodemographic status, information about HIV infection, and the Beck Anxiety Inventory (BAI). Additionally, some opinions of the participants about COVID-19 were asked. Results: A total of 307 respondents, with a median age of 33 years, from 32 different cities, participated in the study. More than half of the respondents reported the belief that COVID-19 was not sufficiently well-known by the medical community and nearly 45% believed that they would have snore complications if they contracted COVID-19. One-fourth of the participants had anxiety. Having a preexisting psychiatric disorder, perceiving that they were practicing insufficient preventive measures, not being sure about the presence of any individuals with COVID-19 in their environment, and living with a household member with a chronic disease were found to be the risk factors of PLHIV for having anxiety during this pandemic. The BAI scores were correlated with the patient-reported anxiety levels about the spread of COVID-19 in Turkey, acquiring COVID-19, transmitting COVID-19 to another person, and transmitting HIV to another person. Among the stated conditions, the most common concern was the spread of COVID-19 all over the country, while the least common was transmitting HIV to someone else. Conclusion: The results revealed that a significant proportion of the sample had anxiety, and the findings were essential for developing evidence-based strategies for decreasing the anxiety of PLHIV, especially for those who had risk factors and to provide them with better health care during this pandemic or other pandemic-like crises

Risk Factors for Gastrointestinal Colonization by ESBL-Producing Klebsiella pneumoniae and Escherichia coli in Anaesthesiology and Reanimation Intensive Care Unit

WOS: 000339539100003PubMed ID: 23621722In this study it was aimed to investigate the risk factors for gastrointestinal colonization by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli in intensive care unit (ICU) of anaesthesiology and reanimation, Ege University Faculty of Medicine, Izmir, Turkey. This study was performed prospectively on adult patients hospitalized in ICU of anaesthesiology and reanimation and rectal swab cultures were performed in all patients in the first 48 hours of hospitalization and every one week until discharge or death. Samples were transported to the laboratory in Stuart transport medium and were cultured on two EMB agar plates (one including 4 mg/L ceftazidime) and incubated for 48 hours. E.coli and K.pneumoniae isolates were identified by conventional methods. Antibiotic susceptibility tests were performed by disc diffusion method on Mueller Hinton agar and interpreted according to CLSI guidelines. ESBL was confirmed by double disc synergy test. A total of 140 patients (49 female 91 male; age range: 18-83 years, mean age: 56.3 years) were evaluated, and 41(29.3%) of the patients were found to be colonized with ESBL positive E.coli (n=39) or K.pneumoniae (n=2). The mean time for colonization was 11.15 +/- 10.91 (range between 2-39) days. Age and gender of the patients and antibiotic consumption before or during the stay in ICU of anaesthesiology and reanimation were not found to be associated with colonization (p>0.05). However length of ICU of anaesthesiology and reanimation stay in colonized patients was longer than non-colonized patients (27.59 +/- 22.52 vs. 17.78 +/- 11.74 days; p<0.05). Infectious episodes developed in 22% (9/41) of the colonized cases and three of the nine strains were isolated from the blood cultures, five from the urine cultures and one from both blood and bronchoalveolar lavage cultures. ESBL-positive E.coli or K.pneumoniae colonization was found as an independent risk factor for the development of infection (9/41 vs. 4/99 cases; p=0.002). Forward logistic regression analysis revealed that diabetes mellitus, immunosuppresive drug use and length of intubation were associated with ESBL-positive E.coli or K.pneumoniae colonization (p<0.05). The results of this study indicated that the risk of development of infection was significantly high in intensive care patients colonized by ESBL positive E.coli and K.pneumoniae and the identification of the related risk factors was critically important for the establishment of effective control measures