Demographic, Clinical and Radiological Features of Healthcare Workers and Two Index Cases That Were Infected with COVID-19 (SARS-Cov-2)

To evaluate the index cases leading to the transmission of healthcare workers (HCWs) in Rize/Turkey Recep Tayyip Erdogan University Faculty of Medicine Education and Research Hospital with COVID-19 infection and the clinical features of infected HCWs. The first two COVID-19 test positive patients treated at Rize/Turkey between 10.03.2020 and 12.04.2020 and HCWs those who examined these two patients whose COVID-19 PCR test results were positive were included in this study. In Rize/Turkey, the first and second cases of positive COVID-19 which was recorded on 13.03.2020 on 25.03.2020, 27 HCWs (female, 63%, n = 17 and male, 37%, n = 10 and the mean age was 33.2 ± 6.9 years) who contacted during the treatment of these cases and became COVID-19 positive were examined. The median of symptom duration (days) of the HCWs was 5 days (range: 0–17 days). Fever, 55.6% (n = 15); malaise, 44.4% (n = 12); cough, 40.7% (n = 11); sore throat, 33.3% (n = 9); myalgia, 33.3% (n = 9); dyspnea, 14.8% (n = 4); diarrhea, 22.2% (n = 6); vomiting, 14.8% (n = 4); anosmia, 18.5% (n = 5); ageusia, 22.2% (n = 6) and headache, 37% (n = 10) of the cases. The rates of headache in female HCWs infected with COVID-19 were found to be significantly higher compared to men (52.9%). None of them had severe clinical situation requiring intensive care follow-up or acute respiratory distress syndrome (ARDS). Laboratory measurements of HCWs were carried out at the first when they had symptoms and when they recovered, and results were compared accordingly. The thorax computerized tomography (CT) findings of HCWs were normal in 74.1% (n = 20) of total. HCWs were initially affected by the COVID-19 pandemic. Early measures provided by the Health authorities, access to diagnosis and treatment, and the young age average in HCWs prevented severe outcomes such as severe clinical course and mortality at the beginning of the outbreak

Low serum bilirubin levels associated with subclinical atherosclerosis in patients with obstructive sleep apnea

duman, hakan/0000-0002-1441-7320WOS: 000453041200001PubMed: 30792909Background: Obstructive sleep apnea (OSA) is a chronic, progressive disease that can cause cardiovascular complications and atherosclerosis. We evaluated the relationship between serum bilirubin levels and carotid intima-media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with OSA. Methods: We enrolled 84 consecutive patients with OSA. the patients underwent ultrasonography, polysomnogaphy, and echocardiography. Blood samples were obtained from all of the subjects, which were used for biochemical comparisons. the patients were divided into groups according to cIMT values (0.9 mm). Results: the patient population consisted of 84 OSA patients (mean age: 54.2 + 8.0 years, 62.9% male). the OSA patients with cIMT >= 0.9 had significantly elevated high-sensitive C-reactive protein (hsCRP), Oxygen desaturation index, apnea-hypopnea index (AHI), and significantly lower total and indirect bilirubin levels. Multivariate regression analyses revealed that total bilirubin, hsCRP, and AHI were the independent predictors of subclinical atherosclerosis. There was a negative correlation between total bilirubin and cIMT. Conclusions: This study showed that high hsCRP and low serum total bilirubin levels could be paving the way for the development of subclinical atherosclerosis. Simple measures such as total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with OSA

Is elevated red blood cell distribution associated with mortality in super-elderly patients with community-acquired pneumonia?

WOS: 000407324100013Introduction: the purpose of this study was to determine the association between red blood cell distribution width (RDW) and mortality in super-elderly subjects (>= 90 years) diagnosed with community-acquired pneumonia (CAP). Methods: One hundred twenty subjects in the super-elderly age group diagnosed with CAP were followed up for at least one year after first diagnosis time. It was investigated whether high RDW level and advanced age were associated with mortality. Results: Eighty-three subjects (69%) died, and 37 (31%) survived. Basal RDW level was significantly correlated with mortality (p 13.05% for RDW predicted mortality with specificity of 64.86% and sensitivity of 84.33%, with a negative predictive value (NPV) of 64.86% and a positive predictive value (PPV) of 84.33%. A cut-off value > 92.5 for age predicted mortality with specificity of 72.97% and sensitivity of 54.21%, with NPV of 41.53% and PPV of 81.8%. Cox regression analysis revealed that a RDW cut-off > 13.05%, age cut-off > 92.5 and presence of Alzheimer's disease increased mortality independently 2.6-fold (p=0.002), 1.5-fold (p=0.040) and 2.4-fold (p=0.003), respectively. Conclusions: This is the first study to examine the relationship between RDW, age and mortality specifically in a super-elderly subject aged over 90 with a diagnosis of CAP. RDW level, advanced age and presence of Alzheimer's disease are correlated with mortality in super-elderly subjects (>= 90 years) with CAP

Diagnostic value of serum apelin-13 in patients with pulmonary thromboembolism

WOS: 000445434700023Aim: We aimed to investigate whether serum apelin-13 value could be a novel biomarker in the diagnosis of pulmonary thromboembolism (PTE). Material and Method: the study included 142 patients. 82 of which were diagnosed with PTE and 60 were control cases. Serum apelin-13 level was measured using venous blood samples with the ELISA kit. Results: the serum apelin level was 2219.4 +/- 65.2 ng/mL in the PTE group and 1234.7 +/- 35.5 ng/mL in the control group (p<0.05). Serum apelin-13 was 2495.8 +/- 738.0 ng/mL in the DVT (+) group and 2118.0 +/- 496.8 ng/ml. in the DVT (-) group (p=0.009). the best cut-off value for apelin-13 in the control and PTE groups was determined as 1579 ng/mL Sensitivity was 92.7% and specificity was 96.7% (95% confidence interval: 0.939 to 0.995, area under ROC curve: 0.979, p<0.001). Discussion: This study showed that serum apelin-13 value can be used as new diagnostic biomarker in patients with PTE. Apelin-13 value also elevates in patients with DVT (+). These results suggest that apelin-13 value may be used as a novel biomarker in the patients with acute PTE and DVT (+) in future practice

A Case of Behcet Disease Characterized by the Appearance of a Mass in the Lungs

WOS: 000435637400011A 42-year-old male patient was admitted to the hospital with a cough, hemoptysis, and complaints of pain in his right shoulder and chest for 10 days. the patient had intermittent fever 38 degrees C with chills. Laboratory results were: leucocytes:21.1 K/uL, platelets:564 K/uL, hemoglobin:13.8 g/dl, C-reactive protein: 8.61, and erythrocyte sedimentation rate: 104 mm/h. Physical examination was normal. the patient had a history of smoking 30 packets/year and Behcet disease (BD) for seven years. Chest radiography showed an increased density on the right paratracheal area. Thorax computed tomography (TCT) revealed a lobulated mass lesion 55x34 mm on the upper lobe of the right lung. Bronchoscopy was performed but neither a mass nor a bleeding focus was detected. A CT-guided transthoracic fine-needle aspiration biopsy was performed. the pathological examination was reported as ''necrotizing vasculitis.'' These results were compatible with pulmonary involvement of the BD. Immunosuppressive therapy was initiated; after 2 months, a control TCT was within normal limits

Prevalence of non-thyroidal illness syndrome in COPD exacerbation and effect of hypoxaemia and hypercapnia on thyroid functions

OZCELIK, Neslihan/0000-0002-4672-6179WOS: 000535373200001PubMed: 32367619Introduction Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease showing acute exacerbations during its course. Comorbidities often accompany. Non-thyroidal illness syndrome (NTIS) occurs because of the functional impairment in the hypothalamic-pituitary-thyroid axis in severe critical cases. the objective of the current study is to determine the prevalence of NTIS among hospitalised patients due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to reveal the factors affecting thyroid functions. Materials and methods A total of 132 patients hospitalised for AECOPD were enroled. Arterial blood gas samples at room air and venous blood samples for thyroid function tests were obtained within 24 hours following hospitalisation. Results the mean age was 69.3 +/- 9.6 years with male predominance (M/F:130/2). the prevalence of NTIS was 55%. Subgroups of NTIS cases were analysed. Low TSH levels were the most common pathology (55%). Patients with NTIS had significantly lower PaO2 and SaO(2) levels compared with those without NTIS (P = 0.045 and P = 0.022, respectively). in addition, a positive correlation was found between PaO2 and free thyroxine (fT4) (P < 0.001, r = 0.313). A statistically significant negative correlation between PaCO2 and fT4 was found (P < 0.001, r = -0.393). and a statistically significant negative correlation between PaCO2 and free triiodothyronine (fT3) values were found (P = 0.040, r = -0.183). Conclusion NTIS is a very common condition during AECOPD. We believe that hypoxemia causing functional impairment in the hypothalamic-pituitary-thyroid axis is the main mechanism in NTIS development and hypercapnia disrupts freeT3 and freeT4 production and secretion

Idiopathic Pulmonary Hemosiderosis with Celiac Disease; Lane-Hamilton Syndrome

WOS: 000396416600009A 21-year-old male patient presented to our emergency department with the complaints of bloody sputum, respiratory difficulty, lethargy, and fatigue persisting for the previous two days. Fingertip oxygen saturation was 92%, while other vital signs were normal. Bilateral ground-glass opacities were present at thoracic computerized tomography. Laboratory findings were hemoglobin: 8.85g/dL, hematocrit: 28.7%. PT and aPTT values were normal. All rheumatologic laboratory tests were negative. Bronchoalveolar lavage was mildly hemorrhagic and "hemosiderin-laden macrophages" were observed in pathology specimens. the case diagnosed withidiopathic pulmonary hemosiderosis (IPH). Gastroduodenoscopy revealed nodularity in the duodenum, and mucosal biopsies taken from these duedonal regionswere reported as "villous atrophy in mucosal tissues in the duodenum compatible with celiac disease". the only recommended treatment was a gluten-free diet. At follow-up approximately 6 months later, complete remission was achieved. in conclusion, we should be aware, when seeing alveolar hemorrhage related to IPH, that celiac disease can accompany IPH. the concurrence of IPH and celiac disease is known as Lane-Hamilton syndrome. Complete remission in Lane-Hamilton syndrome can be achieved with a gluten-free diet

A rare case of interrupted inferior vena cava with azygos continuation

WOS: 000512915500003The identification of vascular pathologies of the mediastinum is very important for the prevention of complications during the interventional procedure. A rare developmental anomaly of inferior vena cava (IVC): the interrupted IVC continues with azygos vein in thorax. and then, the azygos vein merges with the superior vena cava (SVC) and pours into the right atrium. the incidence is reported to be 0.6%. It is a crucial application to distinguish the enlarged azygos vein from the right paratracheal mass and lymph node radiologically and clinically

Syncope as a subject of the risk assessment of pulmonary thromboembolism to be used for: A cross-sectional study

WOS: 000437844500017PubMed: 29498800IntroductionSyncope is infrequent in pulmonary thromboembolism (PTE) yet might be indicative of haemodynamic instability. the prognostic role of syncope in PTE has not been well documented. ObjectivesIn this study, the association between risk classification of the European Society of Cardiology and syncope was investigated in the normotensive PTE patients. MethodsWe retrospectively screened electronic medical records of patients who were admitted in 2 tertiary care hospital and diagnosis of PTE with computed tomography pulmonary angiography. Patients with hypotension (high risk) at the time of admission were excluded from the study. ResultsOf 5% patients (16/322) had syncope with the proportion of 81.3% (13/16) in the intermediate high risky group, 18.7% (3/16) in intermediate low risk group and 0% in low risk group. Mortality rate was higher in subjects with syncope (25% vs 11.1%) although it was not it was not statistically significant (P=NS). in those with syncope, the central venous thrombus was more frequent than those without it (78.6% vs 30.1%, P=.008). Only heart rate and intermediate high-risk group were retained as independent predictors of syncope selection in the multivariate logistic regression. ConclusionAlthough syncope is positively correlated with the severity of PTE, it does not predict the prognosis alone. Nonetheless, syncope in patients with PTE can be considered as an important alarming stimulus for clinical course