Geographical Features and Seroprevalence of Borrelia burgdorferi in Erzincan, Turkey

Background: We aimed to determine the geographical features and seroprevalence of Borrelia burgdorferi in Erzincan, Turkey, which has a high tick population due to its geographical position and climatic conditions. Methods: From January to December 2014, 368 people living in Erzincan, northeastern Turkey were enrolled. B. burgdorferi IgG antibodies were investigated in the collected serum samples using the ELISA method in 2015. Positive and borderline results were confirmed using the Western Blot (WB) method.  Results: Borrelia burgdorferi IgG positivity was found to be 4.1% by ELISA and 2.17% by WB. Of the seropositive people according to WB, 25% resided in areas within 2000m of rivers, 50% in areas with a slope of 0–5°, and 62.5% in areas with an altitude of lower than 1500 meters. Conclusion: The seroprevalence of Lyme borreliosis was high in Erzincan, particularly among people engaged in animal husbandry in rural areas. In addition, the seroprevalence of Borrelia varied according to geographical features, increasing in areas with a lower slope and altitude

The role of the serum inflammatory markers for predicting the tubo-ovarian abscess in acute pelvic inflammatory disease: a single-center 5-year experience

WOS: 000314761000017PubMed ID: 23104053To compare patients with tubo ovarian abscess (TOA) and non-TOA acute pelvic inflammatory disease (PID) and to determinate admitted day laboratory cut-off values for the TOA. Files of inpatients admitted to our clinic with the diagnoses of PID and/or TOA between the years of 2006 and 2011. Laboratory and culture results were obtained from the database of hospital. A total of 73 patients diagnosed with PID and/or TOA were evaluated. Patients who were diagnosed with TOA and PID by physical and sonographic examination were assigned to group 1 and group 2, respectively. Both groups were compared in terms of laboratory, clinical, and epidemiological parameters. Of 73 patients admitted with the diagnosis of PID, 44 (60.3 %) were found to have TOA, and 29 (39.7 %) were not found. Mean age of patients was determined as 41.4 +/- A 7.7 in group 1 and as 35.1 +/- A 6.8 in group 2. Abscess was detected more frequently in patients with low socio-cultural level, and this was found to be statistically significant. The diameter of abscess was found to be a parts per thousand yen5 cm in 39 (88.6 %) patients and 19.5 mm/1/2 h and CRP > 11.5 mg/L were the best predictors of TOA. The high level of CRP and ESR was associated with longer duration of hospitalization and disease severity, and these levels were statistically significantly associated with TOA size of a parts per thousand yen5 cm

Factors Associated with Hemorrhagic Transformation in Infarctions Involving the Posterior Circulation System

PubMed ID: 31138479Backgrounds and Purpose: Hemorrhagic transformation (HT) following stroke of the posterior circulation is a rare occurrence, and its risk factors remain relatively unknown. This study aimed at examining the rate of HT and its risk factors in patients enduring acute ischemic stroke in the territories of the vertebral, basilar, and posterior-cerebral arteries. Materials and Methods: A total of 217 consecutive patients the risk factors for ischemic stroke were recorded and comprehensive biochemical, cardiac assessments, and neuroimaging were performed. National Institutes of Health Stroke Scale (NIHSS) scores were calculated for each patient. Those with HT as documented with neuroimaging based on the European Cooperative Acute Stroke Study criteria and potential risk factors were assessed. Results: There were 217 participants with a mean age of 67.33 ± 12.44 years. Among 17 patients (7.8%) developing HT, 8 (47%) had parenchymal hematoma, and 9(53.5%) had hemorrhagic infarction. Cardioembolism was the most frequent etiological factor both in the overall group (31.0%) as well as in those with HT (41.2%). Factors that emerged as significant predictors of HT included high systolic (odds ratio [OR] 1.14; 95% confidence interval [CI] 1.08-1.20; P< .001) and diastolic blood pressure (P= .001) on the day of admission and the infarction volume of greater than or equal to 3.60 ± 3.29 cm³(OR 1.00, 95% CI 1.00-1.01; P< .001). While NIHSS scores were not significantly different on Day 1, HT patients had higher NIHSS scores at Day 10(OR 1.22; 95% CI 1.09-1.36; P< .001), and this difference was also reflected in mRS at the end of the 3 month period. Conclusion: HT is a rare complication of the infarction of the posterior circulation that is associated with increased morbidity and mortality. Identification of predictive factors for HT in patients with the acute infarction of the posterior circulation may facilitate patient selection for thrombolytic treatment. © 2019 Elsevier Inc

Atherosclerosis And Inflammatory Status In Chronic Kidney Disease Patients After Renal Transplantation: Where Are We Now?

Cardiovascular diseases are the most common cause of mortality and morbidity in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), receiving haemodialysis, peritoneal dialysis, and renal transplantation (Rtx). Estimated glomerular filtration rate (eGFR) places Rtx patients in one of the stages of CKD. Therefore, Rtx patients might be considered a subset of CKD patients. Besides the traditional risk factors of hypertension, diabetes, and dyslipidaemia, advanced-age novel risk factors such as endothelial dysfunction, vascular calcification, and increased chronic low-grade inflammation are highly prevalent and seem to play a more important role for vascular disease in CKD and Rtx patients compared to the general population. The role of Rtx in terms of atherogenesis and chronic ongoing low-grade inflammation is still unclear. To date, in the literature, the data are scant regarding the relationship between atherosclerosis, chronic inflammation, and cardiovascular events in Rtx patients with well-functioning kidneys. This review will discuss classical and recent epidemiological, pathophysiological, and clinical aspects of atherosclerosis and inflammation in Rtx patients

Multisystemic Side Effects of an Indispensable Old Drug: A Case Report of Chronic Lithium Use (A Patient with Multiple Side Effects of Lithium)

Presented here is a case of long-term lithium use, with multiple emerging lithium-associated side effects. An 82-year-old woman was brought into the emergency department because of loss of consciousness. According to the physical examination and laboratory analyses, patient was diagnosed with lithium-associated hypercalcemia, hyperparathyroidism, nephrogenic diabetes insipidus (NDI), symptomatic sinus bradycardia, and thyroid dysfunction. In the literature, there is a limited number of case reports with lithium induced multiple clinical conditions. Multiple clinical manifestations due to the side effects of chronic lithium use might be seen. Health care professionals should keep in mind that lithium-related side effects might trigger or exacerbate each other. To avoid toxicity, close follow-up and clinical supervision are important for the early diagnosis and treatment of these side effects, due to the narrow therapeutic index and obscure clinical signs and symptoms of toxicity

Neutrophil-to-lymphocyte ratio as a possible indicator of epicardial adipose tissue in patients undergoing hemodialysis

WOS: 000390981200011PubMed: 28144263Introduction: Chronic inflammation is a major risk factor in the pathogenesis of cardiovascular disease in end-stage renal disease (ESRD) patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT was shown in healthy subjects and ESRD patients. In the present study we aimed to investigate the relationship between EAT and inflammation parameters including neutrophil-to-lymphocyte ratio (NLR) in hemodialysis (HD) patients. Material and methods: Forty-three HD patients (25 females, 18 males; mean age: 64.1 11.9 years) receiving HD and 30 healthy subjects (15 females, 15 males; mean age: 59.1 +/- 10.8 years) were enrolled in the study. Epicardial adipose tissue measurements were performed by echocardiography. Results: Neutrophil-to-lymphocyte ratio levels were significantly higher in HD patients than in the healthy control group. Hemodialysis patients were separated into two groups according to their median value of NLR (group 1, NLR < 3.07 (n = 21) and group 2, NLR 3.07 (n = 22)). Group 2 patients had significantly higher EAT, C-reactive protein and ferritin levels, while albumin levels were significantly lower in this group. In the bivariate correlation analysis, EAT was positively correlated with NLR (r = 0.600, p < 0.001) and ferritin (r = 0.485, p = 0.001) levels. Conclusions: Neutrophil-to-lymphocyte ratio was found to be an independent predictor of EAT in HD patients (odds ratio = 3.178; p = 0.008). We concluded that this relationship might be attributed to increased inflammation in uremic patients

The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study

WOS: 000392937800028PubMed ID: 28006774Background/Aims: Fabry disease is a treatable cause of chronic kidney disease (CKD) characterized by a genetic deficiency of a-galactosidase A. European Renal Best Practice (ERBP) recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. Methods: This prospective study assessed a-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. Results: Three (all males) of 313 CKD patients (0.95%) were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%), tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%), heat intolerance (71%), and abdominal pain (57%). The most frequent manifestations in female patients were fatigue and cornea verticillata (50%), and tinnitus, vertigo and angiokeratoma (25%). Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. Conclusions: The prevalence of Fa bry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin. (C) 2016 The Author(s) Published by S. Karger AG, BaselSanofi Genzyme Corporation; Intensificacion ISCIII and REDINREN [RD012/0021]We are indebted to our patients and their families for volunteering to contribute their medical information to the physicians who are dedicated to their care. This work was supported by grants from Sanofi Genzyme Corporation. The lead investigator had full access to all data in the study. All investigators take responsibility for the accuracy of the individual data that they entered in the system provided by FMF Arthritis Vasculitis and Orphan disease Research (FAVOR). AO was supported by Intensificacion ISCIII and REDINREN RD012/0021