Skin prick test results in patients from thrace region presenting with pulmonary symptoms

Amaç: Bu çalışmada Pulmoner semptomlarla başvuran hastalarda alerjen duyarlılığı profilinin belirlenmesi amaçlandı. Hastalar ve Yöntemler: Ekim 1999-Nisan 2005 tarihleri arasında pulmoner yakınmalarla başvuran 196 hastada (136 kadın, 60 erkek; ort. yaş 34.7±11.7) yapılan deri testi sonuçları, total IgE sonuçları ve alerji bilgi formları geriye dönük olarak incelendi. Bulgular: Çalışmaya alınan hastaların IgE medyan değeri (%25-75) 202 U/ml (118-530) idi. En sık görülen semptom %65.3 ile nefes darlığı iken ikinci sıklıkta başvuru nedeni %63.8 ile öksürüktü. Bu semptomlar %46.9 hastada toz alırken artmaktaydı. Hastaların %59.7'sinde en az bir alerjene duyarlık saptandı. Tek alerjen ile duyarlılık %18.9 iken çok alerjene duyarlılık %40.8 olarak tespit edildi. En sık %39.8 ile ev tozu akarlarına karşı alerji tespit edilirken ikinci sıklıkta %26 ile ağaç polenlerine karşı saptandı. D. Farinea'ya %33.7, D. Pteronyssinus'a %32.7 duyarlık saptandı. Sonuç: Trakya Bölgesi'nden alerjik semptomlarla başvuran hastalarda en sık ev tozu akarlarına karşı duyarlılık saptandı. Olguların %46.9'unda da semptomların evde, toz alırken artması bu bulguyu destekler nitelikteydi.Objectives: The aim of the study was to determine the profile of allergen sensitization in patients presenting with pulmonary symptoms. Patients and Methods: Skin test results of 196 patients (136 females, 60 males; mean age 34.7±11.7 years) presenting with pulmonary complaints between October 1999 and April 2005; total IgE results and allergy information forms were analyzed retrospectively. Results: Median value of IgE was (%25-75) 202 U/ml (118-530) in the patients enrolled. The most frequent symptom was shortness of breath (65.3%), and the second was cough (63.8%). These symptoms aggravated while patients were dusting. Sensitivity to at least one allergen was observed in 59.7% of the patients. Sensitivity to a single allergen was present in 18.9% and to multiple allergens in 40.8% of all patients. The most frequent allergy was determined to house dust mite (39.8%) and was followed by allergy to tree pollens (26%). Sensitivity rate to D. Farinea was 33.7% and 32.7% to D. Pteronyssinus. Conclusion: House dust mite were the primary causes of sensitization in patients presenting with allergic symptoms in the Thrace region. The fact that the symptoms aggravated in 46.9% of the patients while they were dusting at home, seemed to support this finding

Pulmonary involvement in brucellosis: Case report

Bruselloz, Gram-negatif bakteri ailesinden Brusella türü bakterilerle oluşan zoonotik bir hastalı ktır. Bakteri başta retiküloendotelyal sistem olmak üzere eklem, kalp, böbrek gibi multisistemik tutulum gösterir. Bulaşma yollarından biri inhalasyon olmasına rağmen akciğer tutulumu nadirdir. Göğüs ağrısı, nefes darlığı şikayetiyle başvuran 72 yaşındaki kadın hasta pnömoni öntanısıyla yatırıldı. Yakınmaların antibiyotik tedavisiyle geçmemesi üzerine hastaya, pulmoner emboli düşünülerek çekilen bilgisayarlı tomografide trombüs saptanmadı; ancak, sol akciğer lingular segment, sağ orta lob ve iki taraflı alt loblarda buzlu cam opasitesi izlendi. Kan kültürlerinde Brusella üremesi üzerine spesifik antibiyoterapiye başlandı. Hastanın takiplerinde yan ağrısı düzeldi ve venöz tromboemboliyi düşündürecek herhangi bir gelişme olmadı.Brucellosis is a zoonotic disease caused by a Gramnegative bacillus of the Brucella gender. Involvement is multisystemic primarily affecting the reticuloendothelial system, joints, heart, and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare. A 72-year-old female patient presented with complaints of chest pain and shortness of breath. She was admitted with a preliminary diagnosis of pneumonia. She did not respond to antibiotic therapy. Computed tomography performed for the differential diagnosis of pulmonary embolism showed no evidence for thrombus, but ground glass opacities in the lingular segment of the left lung, the right middle lobe, and bilateral lower lobes. Specific antibiotic therapy was started upon detection of Brucella spp. by hemoculture. The patient's pain disappeared and no sign of venous thromboembolism was observed

Do gender and torus mandibularis affect mandibular cortical index? A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The interactions between torus and several factors such as age, gender, and dental status have not been studied comprehensively. The purpose of this study was to determine the effect of gender on the mandibular cortical index (MCI) and to investigate a possible association between torus mandibularis (TM) and MCI.</p> <p>Methods</p> <p>The study consisted of 189 consecutive patients referred to Department of Oral Diagnosis and Radiology of Hacettepe University within 30 workdays. Patients who did not have systemic disorders affecting bone density were included; and the age, gender, dental status and existing TM of the patients were recorded. Morphology of the mandibular inferior cortex was determined according to Klemitti's classification on panoramic radiographs.</p> <p>Results</p> <p>MCI was affected by age and gender (<it>P </it>< 0.05). No significant relationship was found between TM and MCI (<it>P </it>> 0.05).</p> <p>Conclusion</p> <p>In the study population, MCI was affected by age and gender. As age increased, semilunar defects could be seen on the cortex of the mandible and MCI values increased. Women appeared to have higher MCI values than men.</p

Recent advancements in the breeding of sorghum crop: current status and future strategies for marker-assisted breeding

Sorghum is emerging as a model crop for functional genetics and genomics of tropical grasses with abundant uses, including food, feed, and fuel, among others. It is currently the fifth most significant primary cereal crop. Crops are subjected to various biotic and abiotic stresses, which negatively impact on agricultural production. Developing high-yielding, disease-resistant, and climate-resilient cultivars can be achieved through marker-assisted breeding. Such selection has considerably reduced the time to market new crop varieties adapted to challenging conditions. In the recent years, extensive knowledge was gained about genetic markers. We are providing an overview of current advances in sorghum breeding initiatives, with a special focus on early breeders who may not be familiar with DNA markers. Advancements in molecular plant breeding, genetics, genomics selection, and genome editing have contributed to a thorough understanding of DNA markers, provided various proofs of the genetic variety accessible in crop plants, and have substantially enhanced plant breeding technologies. Marker-assisted selection has accelerated and precised the plant breeding process, empowering plant breeders all around the world

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

Background We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15–20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases. Methods We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded. Results No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5–528.7, P = 1.1 × 10−4) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3–8.2], P = 2.1 × 10−4). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1–2635.4], P = 3.4 × 10−3), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3–8.4], P = 7.7 × 10−8). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10−5). Conclusions Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

BACKGROUND: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences. METHODS: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes. RESULTS: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1–6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2<90% for 60 s) was reported in 40%. No associated risk factors could be identified among co-morbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality. CONCLUSIONS: The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event

Morbidity and mortality after anaesthesia in early life: results of the European prospective multicentre observational study, neonate and children audit of anaesthesia practice in Europe (NECTARINE)

BACKGROUND: Neonates and infants requiring anaesthesia are at risk of physiological instability and complications, but triggers for peri-anaesthetic interventions and associations with subsequent outcome are unknown. METHODS: This prospective, observational study recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. The primary aim was to identify thresholds of pre-determined physiological variables that triggered a medical intervention. The secondary aims were to evaluate morbidities, mortality at 30 and 90 days, or both, and associations with critical events. RESULTS: Infants (n=5609) born at mean (standard deviation [sd]) 36.2 (4.4) weeks postmenstrual age (35.7% preterm) underwent 6542 procedures within 63 (48) days of birth. Critical event(s) requiring intervention occurred in 35.2% of cases, mainly hypotension (>30% decrease in blood pressure) or reduced oxygenation (SpO2 <85%). Postmenstrual age influenced the incidence and thresholds for intervention. Risk of critical events was increased by prior neonatal medical conditions, congenital anomalies, or both (relative risk [RR]=1.16; 95% confidence interval [CI], 1.04–1.28) and in those requiring preoperative intensive support (RR=1.27; 95% CI, 1.15–1.41). Additional complications occurred in 16.3% of patients by 30 days, and overall 90-day mortality was 3.2% (95% CI, 2.7–3.7%). Co-occurrence of intraoperative hypotension, hypoxaemia, and anaemia was associated with increased risk of morbidity (RR=3.56; 95% CI, 1.64–7.71) and mortality (RR=19.80; 95% CI, 5.87–66.7). CONCLUSIONS: Variability in physiological thresholds that triggered an intervention, and the impact of poor tissue oxygenation on patient's outcome, highlight the need for more standardised perioperative management guidelines for neonates and infants

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

X-linked recessive TLR7 deficiency in ~1% of men under 60 years old with life-threatening COVID-19

Autosomal inborn errors of type I IFN immunity and autoantibodies against these cytokines underlie at least 10% of critical COVID-19 pneumonia cases. We report very rare, biochemically deleterious X-linked TLR7 variants in 16 unrelated male individuals aged 7 to 71 years (mean, 36.7 years) from a cohort of 1202 male patients aged 0.5 to 99 years (mean, 52.9 years) with unexplained critical COVID-19 pneumonia. None of the 331 asymptomatically or mildly infected male individuals aged 1.3 to 102 years (mean, 38.7 years) tested carry such TLR7 variants (P = 3.5 × 10−5). The phenotypes of five hemizygous relatives of index cases infected with SARS-CoV-2 include asymptomatic or mild infection (n = 2) or moderate (n = 1), severe (n = 1), or critical (n = 1) pneumonia. Two patients from a cohort of 262 male patients with severe COVID-19 pneumonia (mean, 51.0 years) are hemizygous for a deleterious TLR7 variant. The cumulative allele frequency for deleterious TLR7 variants in the male general population is <6.5 × 10−4. We show that blood B cell lines and myeloid cell subsets from the patients do not respond to TLR7 stimulation, a phenotype rescued by wild-type TLR7. The patients’ blood plasmacytoid dendritic cells (pDCs) produce low levels of type I IFNs in response to SARS-CoV-2. Overall, X-linked recessive TLR7 deficiency is a highly penetrant genetic etiology of critical COVID-19 pneumonia, in about 1.8% of male patients below the age of 60 years. Human TLR7 and pDCs are essential for protective type I IFN immunity against SARS-CoV-2 in the respiratory tract