Tuberculous Meningitis in Adults: A Review of 160 Cases

Objective. This study aimed to evaluate epidemiological, clinical, laboratory, and neuroimaging features of 160 adult patients with tuberculous meningitis (TBM) according to “Thwaites' diagnostic index.” Methods. The subjects of this retrospective study are the patients with TBM who were followed up between years 1998 and 2009 in a tertiary referral hospital. Diagnosis of TBM was based on clinical, laboratory, and neuroimaging signs and Thwaites' diagnostic index. Results. Mycobacterium tuberculosis was isolated from CSF in 59 of 148 patients. Seventeen percent of the patients died, 71% recovered completely, and 13% recovered with neurological sequel at the end of the sixth month. Conclusions. Despite new developments in laboratory or neuroimaging techniques, the diagnosis of TBM is still based on clinical features with the help of laboratory. Early diagnosis by suspecting TBM may prevent therapy delay and may result in decrease in the mortality and morbidity

Efficacy of preheated chelating agents on calcium ion removal from instrumented root canals

The heating of chelating agents such as EDTA increases dentin wettability by decreasing surface tension. However, the calcium ion release effect of preheated chelating agents in instrumented root canals has not yet been mentioned. In this s

Tricuspid Endocarditis and Septic Pulmonary Embolism in an Intravenous Drug User with advanced HIV Infection

Abstract Cardiac complications are becoming increasingly important in patients with HIV infection. Right-sided endocarditis are more common in intravenous drug users (IVDU) with HIV infection. Some studies have pointed out that the clinical outcome of such patients depends on the affected valve referred to the responsible agent rather than the HIV serostatus. However, severe immunosupression and low CD 4 count are associated with increased risk of death. This report presents a case of isolated tricuspid valve endocarditis with advanced HIV infection who was also an IVDU

Hipoteza studije: dob, spol, prisutnost šećerne bolesti ili hipertenzije i antihipertenzivni lijekovi su neovisni čimbenici rizika za smrtnost kod infekcije COVID-19

We aimed to investigate the effects of comorbid diseases and antihypertensive drugs on the clinical outcome of hospitalized patients with COVID-19 infection. A total of 1045 patients whose data could be gathered and confirmed from both hospital files and Turkish National Health Network records were retrospectively screened, and 264 of 1045 patients were excluded because of having more than one comorbid disease. The study population consisted of a total of 781 patients, of which 482 had no comorbid disease, while the remaining 299 patients had only one comorbid disease. The mortality risk was 7.532 times higher in those over 65 years of age compared to cases younger than 30 years (OR: 7.532; 95% CI: 1.733-32.730); the risk of mortality in men was 2.131 times higher than in women (OR: 2.131; 95% CI: 1.230-3.693); and presence of diabetes mellitus (DM) increased mortality risk 2.784 times (OR: 2.784; 95% CI: 1.288-6.019). While hypertension was not found to be an independent risk factor for COVID-19 mortality, age, gender, and presence of DM were independent risk factors for COVID-19 mortality. There was no association between antihypertensive drugs and mortality. Accordingly, age (>65 years), gender (male), and presence of DM were independent risk factors for COVID-19 mortality, whereas hypertension and use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and their combinations with other antihypertensive drugs were not risk factors for COVID-19 mortality.Cilj istraživanja bio je ispitati učinak supostojećih bolesti i antihipertenzivnih lijekova na klinički ishod hospitaliziranih bolesnika s infekcijom COVID-19. Retrospektivnim probirom obuhvaćeno je ukupno 1045 bolesnika čije podatke smo mogli prikupiti i potvrditi iz bolničkih kartona i zapisa Turske nacionalne zdravstvene mreže; od tih bolesnika njih 264 je isključeno, jer su imali više od jedne supostojeće bolesti. Tako je u studiju uključen ukupno 781 bolesnik, od kojih njih 482 nisu imali nikakve supostojeće bolesti, dok je preostalih 299 imalo samo jednu supostojeću bolest. Rizik od smrtnog ishoda bio je 7,532 puta veći kod bolesnika starijih od 65 godina u usporedbi sa slučajevima mlađim od 30 godina (OR: 7,532; 95% CI: 1,733-32,730); rizik od smrtnog ishoda bio je 2,131 puta veći kod muškaraca u nego kod žena (OR: 2,131; 95% CI: 1,230-3,693); prisutnost dijabetes melitusa (DM) povećala je rizik od smrti 2,784 puta (OR: 2,784; 95% CI: 1,288-6,019). Hipertenzija nije utvrđena kao čimbenik rizika za smrtnost kod infekcije COVID-19, ali su se dob, spol i prisutnost DM pokazali neovisnim rizičnim čimbenicima za smrtnost kod infekcije COVID-19. Prema tome, dob (iznad 65 godina), spol (muški) i prisutnost DM utvrđeni su kao neovisni čimbenici rizika za smrtnost kod infekcije COVID-19, dok hipertenzija i uzimanje inhibitora angiotenzin-konvertirajućeg enzima, blokatora receptora angiotenzina i njihovih kombinacija s drugim antihipertenzivnim lijekovima nisu utvrđeni kao rizični čimbenici smrtnosti kod infekcije COVID-19

Tricuspid Endocarditis and Septic Pulmonary Embolism in an Intravenous Drug User with advanced HIV Infection

Cardiac complications are becoming increasingly important in patients with HIV infection. Right-sided endocarditis are more common in intravenous drug users (IVDU) with HIV infection. Some studies have pointed out that the clinical outcome of such patients depends on the affected valve referred to the responsible agent rather than the HIV serostatus. However, severe immunosupression and low CD4 count are associated with increased risk of death. This report presents a case of isolated tricuspid valve endocarditis with advanced HIV infection who was also an IVDU

Immune Thrombocytopenia in a Very Elderly Patient With Covid-19

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a decreased number of platelets and mucocutaneous bleeding. Many viruses have been identified as triggers of the autoimmune process, including human immunodeficiency virus (HIV), hepatitis C virus (HCV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus, rubella, and measles. Association with the new severe acute respiratory syndrome coronavirus, SARS-CoV-2 infection (Covid-19 infection) has been rarely reported. Here, we report the oldest case of ITP patient triggered by the novel coronavirus infection. He showed inadequate response to IVIG but responded to corticosteroids with no severe adverse events. Further studies are warranted to determine the optimal therapeutic strategies for ITP with the Covid-19 infection