Antibody responses of COVID-19 patients according to symptoms and the presence of pneumonia

Introduction: The aim of the study was to examine the 30-day total SARS-CoV-2 antibody positivity in patients across a clinical spectrum ranging from asymptomatic to pneumonia.Methods: This prospective cohort study consisted of 51 consecutive patients who were RT-PCR positive and diagnosed COVID-19 pneumonia (Group 1) and 58 consecutive patients who were also RT-PCR positive but were asymptomatic or had mild symptoms (Group 2). On the 30th day from the date of symptom onset, the patients were called for examination and blood samples were taken for the detection of SARS-CoV-2 antibodies.Results: Patients with pneumonia, fever, muscle pain, and loss of taste and smell had significantly higher rates of antibody positivity (p= 0.001, 0.003, 0.030, and 0.018, respectively). Antibody positivity was found to be significantly higher in patients with at least one symptom on admission compared to asymptomatic patients (p = 0.001). While the antibody positivity rate was 96.1% in Group 1 (patients with pneumonia), it was 50% in Group 2 (patients without pneumonia), and 77.7% in patients with at least one symptom on admission compared to 33.3% in asymptomatic patients (p=0.001).Conclusions: Patients with COVID-19 pneumonia have significantly higher disease-specific total antibody positivity rates than patients without pneumonia. Considering the 50% antibody positivity in patients who had COVID-19 infection who were asymptomatic or had symptoms other than pneumonia, the issue of COVID-19 re-infection and immunity is much more important than it appears

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

Hastanede yatırılarak tedavi edilmiş ve plevral effüzyon nedeniyle plevral drenaj uygulanmış hastaların retrospektif olarak değerlendirilmesi

Objective: Pleural effusion (PE) is a common pathological condition that can occur during the clinical course of many diseases. This study aimed to retrospectively evaluate the clinical features and treatment results of patients with pleural fluid drainage due to PE. Methods: A retrospective analysis was performed in the study with 103 patients between January 2020 and March 2021, who had pleural drainage due to PE. The posteroanterior and lateral chest radiographs were evaluated. Results: A total of 103 patients were included in the study, with an overall mean age of 62.5 years minimum: 24, maximum: 91 years. Most patients had three or more comorbid diseases (n=53, 51.5%). The majority of patients had drainage using a pleural catheter (n=97, 94.2%). Cytological examination of the pleural fluid revealed malignancy in 5 (4.9%) patients, whereas 89 (86.4%) were discharged during follow-up, and 14 (13.6%) had mortality. In the patients who died, more fluid with exudate characteristics at a level close to statistical significance was detected. Malignant cells were detected in the pleural fluid in 10% of patients with primary malignant cases (n=50), whereas no malignant cell was found in the pleural fluid of patients without malignancy diagnosis (n=53), with a statistically significant difference between patients with and without malignancy. The total length of hospital stay was significantly higher in patients undergoing a second surgical procedure. Conclusion: Patients undergoing pleural fluid drainage had at least one systemic disease. The most common systemic disease in patients was a cardiac disease, followed by malignant disease. "No malignant cells were detected in the fluids of patients without primary malignancy," in the cytology. In addition, the rate of second pleural surgery is high in PE cases, which further prolongs the length of hospitalization of these patients.Amaç: Plevral efüzyon (PE) birçok hastalığın klinik seyri sırasında ortaya çıkabilen ve sık görülebilen bir patolojik durumdur. Bu çalışmada, iç hastalıkları kliniğinde yatırılarak tedavi edilmiş ve PE nedeniyle plevral sıvı drenaj uygulanmış hastaların klinik özelliklerini ve tedavi sonuçlarını retrospektif olarak değerlendirmeyi amaçlanmıştır. Gereç ve Yöntem: Çalışmada Ocak 2020 ile Mart 2021 tarihleri arasında iç hastalıkları kliniğinde yatırılarak tedavi edilmiş ve PE nedeniyle plevral drenaj uygulanmış 103 hasta geriye dönük olarak incelenmiştir. Bu hastalardaki mevcut komorbit hastalıklar kayıt edilmiştir. Bütün hastaların çekilmiş olan posteroanterior ve lateral akciğer grafileri incelenerek sıvı miktarları değerlendirildi. Olguların demografik özellikleri, sıvı analizinde dikkat çeken özellikleri, torasentez dışında kullanılan tanı yöntemleri, drenaj için kullanılan cerrahi yöntemler, işleme ait komplikasyonlar, hastaların yatış süresi ve sağkalım durumları değerlendirildi. Bulgular: Hastaların yaş ortalaması 62,5 yıl minimum: 24, maksimum: 91 yıl idi. Yüz üç hastanın 58’i kadın (%56,3) ve 45’i erkekti (%43,7). Hastaların çoğunluğunda üç ve üzeri komorbidit hastalık mevcuttu (n=53, %51,5). Hastaların çoğunluğuna plevral katater ile drenaj uygulanmıştı (n=97, %94,2). Drenaj sonrasında hastaların %10,7’sinde (n=11) cerrahi girişime ait komplikasyon izlendi. Plevral sıvının sitolojik incelenmesinde hastaların beşinde (%4,9) plevral sıvıda maligniteye rastlandı. Toplam drenaj süresi ortalama 8,8 gün iken (min: 1 gün, maks: 68 gün, IQR=7) toplam hastanede kalış süresi 23,6 gün (min: 3, maks: 103, IQR=19) olarak hesaplandı. Takipte hastaların 89’u taburcu edilirken (%86,4), 14’ü eks olmuştu (%13,6). Eksitus olan hastalarda istatistiksel anlamlılığa yakın düzeyde daha fazla eksüda vasfında sıvı saptandı. Primer malignitesi mevcut olan hastaların (n=50) %10’unda plevral sıvıda malign hücre saptanırken malignite tanısı olmayan hastaların (n=53) hiçbirinde plevral sıvıda malign hücre saptanmamıştı ve bu aradaki fark istatistiksel olarak anlamlıydı (p=0,02). İkinci kez cerrahi girişim gerektiren hastalarda hastanede kalış süresi anlamlı olarak yüksek bulundu. Sonuç: Pleral sıvı drenajı uygulanmış hastalarda en az bir sistemik hastalık mevcuttu. Hastalarda en sık görülen sistemik hastalık kardiyak hastalıklarken ikinci sırada ise malignansiler yer almaktadır. Drenaj sonrası komplikasyon görülebilmekte ancak majör komplikasyon gelişmemektedir. Mortaliteyi etkileyen faktörler sıklıkla hastaya ait olan primer sistemik hastalığa bağlıydı. Primer maligniteye sahip olmayan hastalarda plevral sıvının sitolojik incelemesinde malign hücreye rastlanmadı. Ayrıca PE’lerde ikinci plevral cerrahi işlem oranı yüksektir bu durum hastaların yatış süresini daha da uzatmaktadır

Assessment of relationship between serum magnesium and serum glucose levels and HOMA-IR in diabetic and prediabetic patients

Aim: In this study, we aimed to investigate the serum magnesium (Mg) levels in diabetic and prediabetic patients and its correlation with age, body-mass index, HOMA-IR, serum fasting glucose, HbA1c, and insulin levels.Methods: In this retrospective study, a total of 130 patients consisted of newly diagnosed prediabetes (Group PD) (n=63) and type 2 diabetes mellitus (Group D) (n=67) were included. Patients' age, body mass index, serum Mg, glucose and insulin, HOMA-IR and HbA1c were recorded. The prediabetes and type 2 diabetes diagnoses had been made according to WHO criteria at the time of diagnosis.Results: In group D, the mean Mg level (1.88 ± 0.17 mg/dl) was significantly lower than group PD (1.96 ± 0.17 mg/dl) (p = 0.007). Correlation analysis showed that there was a significant negative correlation between Mg and glucose (r = -0.390, p = 0.001) and HOMA-IR (r = -0.284; p = 0.022) in the group D. No correlation was found between serum Mg level and serum insulin, HbA1c, age, and body-mass index (p = 0.801, 0.087, 0.611 and 0.691, respectively). In group PD, serum insulin, HbA1c, glucose, HOMA-IR, age, and body-mass index were not corraleted with serum Mg levels (p = 0.801, 0.087, 0.939, 0.998, 0.611 and 0.691, respectively). Conclusıon: We showed that while there was a negative correlation between magnesium levels and HOMA-IR and fasting blood glucose levels in diabetic patients, but this correlation was not present in prediabetic patients. Our results suggest that serum Mg level is associated with metabolic control of type 2 diabetes and thus it can be considered in these patients

Adaptation of the professionalism mini-evaluation exercise instrument into Turkish: a validity and reliability study

Abstract Background There is an ongoing search for standardized scales appropriate for each culture to evaluate professionalism, which is one of the basic competencies of a physician. The Professionalism Mini-evaluation Exercise (P-MEX) instrument was originally developed in Canada to meet this need. In this study, it was aimed to adapt the P-MEX to Turkish and to evaluate the validity and reliability of the Turkish version. Methods A total of 58 residents at Bakirkoy Dr. Sadi Konuk Training and Research Hospital were assessed with the Turkish version of P-MEX by 24 raters consisting of faculty members, attending physicians, peer residents, and nurses during patient room visits, outpatient clinic and group practices. For construct validity, the confirmatory factor analysis was performed. For reliability, Cronbach’s alpha scores were calculated. Generalizibility and decision studies were undertaken to predict the reliability of the validated tool under different conditions. After the administration of P-MEX was completed, the participants were asked to provide feedback on the acceptability, feasibility, and educational impact of the instrument. Results A total of 696 forms were obtained from the administration of P-MEX. The content validity of P-MEX was found to be appropriate by the faculty members. In the confirmatory factor analysis of the original structure of the 24-item Turkish scale, the goodness-of-fit parameters were calculated as follows: CFI = 0.675, TLI = 0.604, and RMSEA = 0.089. In the second stage, the factors on which the items loaded were changed without removing any item, and the model was modified. For the modified model, the CFI, TLI, and RMSEA values were calculated as 0.857, 0.834, and 0.057, respectively. The decision study on the results obtained from the use of P-MEX in a Turkish population revealed the necessity to perform this evaluation 18 times to correctly evaluate professionalism with this instrument. Cronbach’s alpha score was 0.844. All the faculty members provided positive feedback on the acceptability, feasibility, and educational impact of the adapted P-MEX. Conclusion The findings of this study showed that the Turkish version of P-MEX had sufficient validity and reliability in assessing professionalism among residents. Similarly, the acceptability and feasibility of the instrument were found to be high, and it had a positive impact on education. Trial registration 2020/249, Bakirkoy Dr. Sadi Konuk Training and Research Hospital

The Effect of Autosomal Dominant Polycystic Kidney Disease on Spirometric Parameters

Aim: There is no enough data on pulmonary involvement in autosomal dominant polycystic kidney disease (ADPKD). The aim of this study is to examine pulmonary function test in patients with ADPKD with varying stages of renal function and to compare them with those in healthy controls

Majčina crijevna mikrobiota u trudnoćama iz kojih su rođena djeca s Downovim sindromom - probno ispitivanje

Down syndrome (DS) is one of the main genetic abnormalities of newborns. Therefore, prenatal diagnosis of this syndrome is of paramount importance to the family and the community. The microbiota system is important in early brain development. We tried to study and compare gut microbiota (GM) composition in pregnancies that resulted in DS neonates with pregnancies that resulted in healthy children. The study population consisted of 21 pregnant women having delivered DS newborns (group 1) and 22 pregnant women who had given birth to healthy newborns (group 2). The GM composition was determined and compared between the two groups. There were no significant age and gestational age differences between the two groups (p>0.005 both). Regarding GM analysis, microorganisms of the families Clostridiaceae and Pasteurellaceae were more abundant in the group of women having delivered DS neonates than the group of women having delivered healthy newborns (p<0.05). The results of our pilot study showed that the GM system might have a role in the pathophysiology of DS. The GM changes may be used in the prenatal diagnosis and prevention of this syndrome. Further studies are needed in this field.Downov sindrom (DS) je jedna od glavnih genetskih nenormalnosti kod novorođenčadi, stoga je prenatalna dijagnostika ovoga sindroma od velike važnosti za obitelj, kao i za društvo. Sustav mikrobiote ima važnu ulogu u ranom razvoju mozga. U ovom istraživanju ispitali smo i usporedili sastav crijevne mikrobiote (CM) u trudnoćama iz kojih su rođena djeca s DS i u trudnoćama iz kojih su rođena zdrava djeca. Istraživana populacija obuhvatila je 21 trudnicu koje su rodile djecu s DS (1. skupina) i 22 trudnice koje su rodile zdravu djecu (2. skupina). Sastav CM utvrđen je i uspoređen među dvjema skupinama. Nije bilo razlike u dobi i gestacijskoj dobi između skupina (p>0,005 oboje). Analiza CM je pokazala da su mikroorganizmi iz porodica Clostridiaceae i Pasteurellaceae zastupljenije u skupini žena koje su rodile djecu s DS u usporedbi sa skupinom žena koje su rodile zdravu djecu (p<0,05). Rezultati našeg probnog ispitivanja pokazuju da bi sustav CM mogao imati ulogu u patofiziologiji DS. Promjene u CM mogle bi se rabiti u prenatalnoj dijagnostici i prevenciji ovoga sindroma. Potrebna su daljnja istraživanja u ovom području

ANNUAL INFLUENZA VACCINATION EFFECT ON THE SUSCEPTIBILITY TO COVID-19 INFECTION

Objectives: We aimed to study the effect of seasonal influenza (flu) vaccination on the susceptibility to coronavirus disease 2019 (COVID-19)

Serum C-Reactive Protein and Sex Hormone Levels in the Early Hyperacute Phase of Stroke

Background: To see the relationship of early admission parameters with the type of stroke and/or with the 30-days mortality from this disease