Brugada-type Electrocardiographic Pattern Induced by Fever

ST-segment elevation in Brugada syndrome is caused by a shift in the ionic current balance and the creation of a voltage gradient between the epicardium and the endocardium. This ionic mechanism have been shown to be temperature dependent. We describe a 33-year-old man who presented with fever with the dynamic electrocardiographic changes similar to the Brugada syndrome. These electrocardiographic anomalies disappeared when the temperature returned to normal

Analysis of antimicrobial consumption and cost in a teaching hospital

SummaryBackgroundThe aim of this study is to compare the periods before and after the intervention applied using the ATC/DDD method in order to ascertain the rational use of antibiotics in a newly established hospital.MethodThe appropriateness of the hospital's antibiotic use, consumption rates and the costs were calculated and compared with other hospitals. Based on these data, an intervention has been planned in order to raise the quality of antibiotic use. The periods before and after the intervention were compared. Between 16 May 2011 and 23 May 2012, data were collected from all hospital units by the infectious diseases specialists and a point prevalence survey was conducted. Anatomical therapeutic chemical classification and the defined daily dose (DDD) methodology were used to calculate the antibiotic consumption.ResultsOn two specific days in 2011 and 2012, 194 out of 307 patients (63.2%) and 224 out of 412 patients (54.4%) received antibiotic treatment, respectively. In 2011 and 2012, the percentage of appropriate antibiotic use was 51% and 64.3%, respectively. Both in 2011 and 2012, inappropriate antibiotic use was found to be significantly higher in surgical clinics in comparison to the internal diseases clinics and the ICU. This was caused by the high rates of inappropriate perioperative antimicrobial prophylaxis observed in surgical clinics. During both years, approximately one-third of the antibiotics were prescribed for the purposes of perioperative prophylaxis, while 88.5% and 43.7% of these, respectively, were inappropriate and unnecessary. Cephalosporins, fluoroquinolones, combinations of penicillins (including β-lactamase inhibitors) and carbapenems were the most frequently prescribed antibiotics during the study periods. The mean total antibiotic consumption was 93.6 DDD/100 bed-days and 63.1 DDD/100 bed-days, respectively. The cost of total antibacterial consumption was € 7901.33 for all the patients (€ 40.72 per infected patient) and € 6500.26 (€ 29.01 per infected patient), respectively.ConclusionEach hospital should follow and assess their antibiotic use expressed in DDD in order to compare their antibiotic use with national and international hospitals (WHO, 2009 [14])

Četverogodišnja studija učinkovitosti i sigurnosti entekavira u bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije

Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naive HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4}41.5 IU /L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU /mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.Entekavir je analog gvanozina koji djeluje protiv virusa hepatitisa B. Cilj ove četverogodišnje studije bio je procijeniti liječenje entekavirom kod bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije. Ukupno je 49 bolesnika primalo entekavir, a devetoro ih se povuklo s terapije na kraju 96. tjedna. Početna srednja vrijednost alanin aminotransferaze bila 79,4}41,5 IU /L, dok je nakon 4 godine vrijednost alanin aminotransferaze bila u normalnim granicama kod 90% bolesnika. U 96. tjednu je <300 kopija HBV DNA zabilježeno u 91,7% bolesnika, a u 48. mjesecu je 48,90% bolesnika imalo <50 IJ/mL HBV DNA. Gubitak HBeAg zabilježen je u 7,1% bolesnika u 96. tjednu te u 12,5% bolesnika u 48. mjesecu. Stopa serokonverzije HBeAg iznosila je 4,8% u 96. tjednu i 7,5% u 48. mjesecu. Stopa serokonverzije HBsAg bila je 2,1% u 96. tjednu i 2,5% u 48. mjesecu. Sigurnost terapije bila je dobra. Bolesnici su dobro podnosili entekavir, snažan i siguran lijek koji dovodi do ustaljenog suzbijanja virusa

Četverogodišnja studija učinkovitosti i sigurnosti entekavira u bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije

Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naive HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4}41.5 IU /L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU /mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.Entekavir je analog gvanozina koji djeluje protiv virusa hepatitisa B. Cilj ove četverogodišnje studije bio je procijeniti liječenje entekavirom kod bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije. Ukupno je 49 bolesnika primalo entekavir, a devetoro ih se povuklo s terapije na kraju 96. tjedna. Početna srednja vrijednost alanin aminotransferaze bila 79,4}41,5 IU /L, dok je nakon 4 godine vrijednost alanin aminotransferaze bila u normalnim granicama kod 90% bolesnika. U 96. tjednu je <300 kopija HBV DNA zabilježeno u 91,7% bolesnika, a u 48. mjesecu je 48,90% bolesnika imalo <50 IJ/mL HBV DNA. Gubitak HBeAg zabilježen je u 7,1% bolesnika u 96. tjednu te u 12,5% bolesnika u 48. mjesecu. Stopa serokonverzije HBeAg iznosila je 4,8% u 96. tjednu i 7,5% u 48. mjesecu. Stopa serokonverzije HBsAg bila je 2,1% u 96. tjednu i 2,5% u 48. mjesecu. Sigurnost terapije bila je dobra. Bolesnici su dobro podnosili entekavir, snažan i siguran lijek koji dovodi do ustaljenog suzbijanja virusa

A Decision Support System for Assessing and Prioritizing Sustainable Urban Transportation in Metaverse

Blockchain technology and metaverse advancements allow people to create virtual personalities and spend time online. Integrating public transportation into the metaverse could improve services and collect user data. This study introduces a hybrid decision-making framework for prioritizing sustainable public transportation in Metaverse under q-rung orthopair fuzzy set (q-ROFS) context. In this regard, firstly q-rung orthopair fuzzy (q-ROF) generalized Dombi weighted aggregation operators (AOs) and their characteristics are developed to aggregate the q-ROF information. Second, a q-ROF information-based method using the removal effects of criteria (MEREC) and stepwise weight assessment ratio analysis (SWARA) models are proposed to find the objective and subjective weights of criteria, respectively. Then, a combined weighting model is taken to determine the final weights of the criteria. Third, the weighted sum product (WISP) method is extended to q-ROFS context by considering the double normalization procedures, the proposed operators and integrated weighting model. This method has taken the advantages of two normalization processes and four utility measures that approve the effect of benefit and cost criteria by using weighted sum and weighted product models. Next, to demonstrate the practicality and effectiveness of the presented method, a case study of sustainable public transportation in metaverse is presented in the context of q-ROFSs. The findings of this study confirms that the proposed model can recommend more feasible performance while facing numerous influencing factors and input uncertainties, and thus, provides a wider range of application

The Incidence and Extent of Mullerian Metaplasias in Ovarian Surface Epithelial Tumors

Objectives: Most ovarian surface epithelial tumors emerge from a background of Mullerian metaplasias. The incidence and extent of Mullerian metaplasias were examined in ovarian surface epithelial tumors. Methods: The incidence of Mullerian metaplasias was evaluated according to the presence of the metaplasias in all cases. The extent of these metaplastic changes was scored from (1+) to (4+) according to the extended area in all tumoral slide sections. Results: Ciliated cell metaplasia was found in 80.4 % of benign tumors, 100 % of borderline tumors and 93.3 % of malignant tumors. Eosinophilic cell metaplasia was present in 13 % of benign tumors, 70 % of borderline tumors and 93.3 % of malignant tumors. Clear cell metaplasia was observed in 17.4 % of benign tumors, 20 % of borderline tumors and 40 % of malignant tumors. While ciliated cell metaplasia was more frequent and extensive in benign tumors, eosinophilic and clear cell metaplasias were more frequent and extensive in borderline and malignant tumors (p<0.05). Conclusions: Our findings suggest that the incidence and extent of Mullerian metaplasias in ovarian surface epithelial tumors may not be homogeneous. This should be taken into account when their biological significances and relation with tumorigenesis are investigated. [J Interdiscipl Histopathol 2012; 1(1.000): 16-22

Adhesion of hemocytes to desialylated prothoracic glands of Galleria mellonella (Lepidoptera) in the larval stage

Earlier work showed the existence of sialic acid (SA) in the prothoracic glands (PGs) of Galleria mellonella (Karacali et al., 1997). In this paper we investigated the role of SA during the degeneration process of PGs. Neuraminidase-digested larval PGs were incubated within the hemolymph collected from same age larvae. Light and electron microscopic observations showed incomplete capsule formation by the accumulation of hemocytes around desialylated gland cells, but not in the control group. Desialylated larval PG cells were recognized as a foreign structure or non-self by hemocytes. The result indicates that SA acts as a mask for hemocytic receptors during the larval period under normal conditions. However, in the absence of SA, the glands start to degenerate. We provide an explanation for the role of SA in the recognition process of hemocytes that initiates the degeneration of PGs in pupal cells and show the functionality of SA in insects, confirming that SA is a universal molecule

Thermal Degradation Behaviour of Ni(II) Complex of 3,4-Methylenedioxaphenylaminoglyoxime

Thermal degradation behaviour of the Ni(II) complex of 3,4-methylenedioxaphenylaminoglyoxime was investigated by TG, DTA, and DTG at a heating rate of 10°C min−1 under dinitrogen. The acquired experimental data shows that the complex is thermally stable up to 541 K. The pyrolytic decomposition process occurs by melting metal complex and metal oxide remains as final product. The energies of the reactions involved and the mechanism of decomposition at each stage have been examined. The values of kinetic parameters such as activation energy (E), preexponential factor (A) and thermodynamic parameters such as enthalpy (ΔH), entropy (ΔS), and Gibbs free energy (ΔG) are also evaluated

DOES NEUTROPHIL / LYMPHOCYTE RATIO CONTRIBUTE TO DIAGNOSTICS IN PATIENTS WITH FASCIOLIASIS?

WOS: 000434986500008Introduction: Fasciolia sp. is a trematode causes infection by settling in the liver bile ducts of domestic animal and human liver. Fascioliasis is a parasite disease that might have changes in liver parenchyma and in bile ducts. Many inflammatory reactions occur during the settlement of larvae and mature parasites into the liver. The neutrophil/lymphocyte ratio (NLR) has become a prominent marker of underlying inflammation. The objective of the present study is to investigate the relationship between the hematological parameters in patients with fascioliasis. Materials and methods: The diagnosis of fascioliasis was based on patient history, clinical and laboratory findings, radiological imaging (ultrasound), stool examination and IgG antibody titer determination by ELISA. Clinical and laboratory data were collected for 56 patients with fascioliasis, and diagnosed with serological and radiological imaging. 56 healthy volunteers were selected for the control group. Stool and blood samples were collected from patients with fascioliasis for serologic, biochemical, hematologic tests and ova examination. Total leukocyte, neutrophil, eosinophil and lymphocyte counts were recorded and NLR was calculated. ELISA antibody cut off titer value of patients with fascioliasis was 10> positive. Results: We compared neutrophil/lymphocyte ratio, eosinophil/lymphocyte ratio, the relation of eosinophilia and IgG antibody titers between two groups (patient and control groups). There was no statistically significant difference between patients and healthy controls neither based on age and gender nor NLR. According to these findings, NLR can not be considered as a diagnostic marker in fascioliasis. Conclusion: As a result, it was determined that NLR is not a crucial indicator of inflammation in parasitic fascioliasis. Extensive studies are need to be done to clarify the correlation between NLR and progression of other parasitic diseases

Cytopenia in adult brucellosis patients

Background & objectives: Brucellosis can lead to haematological abnormalities including cytopenia confusing with haematological malignancies. The aim of this study was to compare the main characteristics of brucellosis patients without cytopenia (Group 1) and with cytopenia (Group 2). Methods: This five-year period study which was performed in two referral hospitals in Turkey, included all adult brucellosis patients. Abnormally, low counts of leucocyte or haemoglobin or platelets in a patient were considered as cytopenia. The demographics, clinical, laboratory, treatment and outcome data were analyzed. Results: A total of 484 brucellosis patients were enrolled. Among the cases, 162 (33.5%) of them had cytopenia. One hundred and four (21.5%) had anaemia, 88 (18.8%) had thrombocytopenia, 71 (14.6%) had leucopenia and 28 (5.8%) had pancytopenia. The mean age of group 2 was 35.01±16.05 yr and it was 33.31±14.39 yr in group 1. While there was no difference between the groups in terms of duration of treatment, the median length of hospital stay (LOS) was significantly longer in group 2 (9 vs 10 days; P<0.001). The most frequently applied combination therapy consisted of doxycycline plus rifampicin and doxycycline plus streptomycin regimens. No significant difference was observed in terms of duration of treatment, LOS and restoration time of cytopenia between the patients who received either of these combinations. Interpretation & conclusions: Our findings suggested that the patients with cytopenia should be investigated for brucellosis, especially if living in, or with a history of travel to, endemic areas, in view of the increase in world travel