Evaluation of absolute CD4+ and CD4/CD8 ratios before and after antiviral treatment in HIV patients: A single-center experience

Aim: The human immunodeficiency virus (HIV) is a disease with dramatic effects on global health policies. The absolute CD4 and CD4/CD8 ratios are better biomarkers for more accurately describing overall immune dysfunction and disease progression, response to therapy, morbidity, viral suppression, and mortality. Therefore, we aimed to evaluate the absolute CD4+ and CD4/CD8 ratios before and after treatment. In addition, the characteristics of HIV-RNA-positive patients were evaluated. Method: In this single-center retrospective study, 50,047 anti-HIV tests performed between January 2022 and September 2022 at Samsun University Training and Research Hospital were evaluated. The absolute CD4 and CD4/CD8 values ​​of 94 patients treated in our center were evaluated before and after treatment. In addition, the characteristics of 276 patients who underwent HIV RNA testing during this time were evaluated. Results: At the specified time, the anti-HIV positivity prevalence was 0.14%. When we compared the absolute CD4 count and CD4/CD8 ratio before and after treatment, we found that both values increased significantly after treatment in the control tests performed in the follow-up of the treatment process. Of the 276 people who underwent HIV RNA testing, 154 (55.80%) were found to be positive. A significant relationship was found between HIV-RNA positivity prevalence and gender. The prevalence of HIV-RNA positive patients was higher in men. Conclusions: To the best of our knowledge, this is the first study evaluating the HIV RNA positive prevalence, the absolute CD4, and the CD4/CD8 ratio in Samsun. Our results will aid in the management of HIV patients

Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis.

AIMS: To determine the level of serum procalcitonin and cerebrospinal fluid cytokines in children with bacterial or viral meningitis and to document the use of these parameters in differential diagnosis. RESULTS: Before the start of antibiotic treatment, serum procalcitonin and tumor necrosis factor alpha levels were found to be higher in acute bacterial meningitis compared with viral meningitis and with the control group. Similarly, cerebrospinal fluid interleukin-6 levels were found to be significantly higher in children with acute bacterial meningitis compared with viral meningitis. However, no significant difference was determined between groups in respect to the cerebrospinal fluid interleukin-8 level. CONCLUSION: Serum procalcitonin and cerebrospinal fluid tumor necrosis factor alpha levels can be used in the early diagnosis of bacterial meningitis. Similarly, they may be useful adjuncts in differential diagnosis of bacterial and viral meningitis

Evaluation of the anatomical and electrical axis of the heart after pneumonectomy

Aim: To investigate the position of the heart after pneumonectomy and, also to find out how the changes in the electrical axis of the heart contribute for the possible electrocardiographic and echocardiographic changes. Methods: Ninety-eight patients with pneumonectomy were included to this observational study. To calculate the rotation of the heart and angle measurement two perpendicular lines, one septal and another atrioventricular, were drawn on the images acquired from thoracic computed tomography. Thoracic CT were taken at every 3 months for the first two years. On electrocardiograms net QRS vectors, amplitudes of p waves, findings of right and left ventricular hypertrophy, and other possible changes were recorded. Results: The mean age of all patients was 55.51 ± 8.9. Right pneumectomy was performed in 40 (57%) and left pneumonectomy in 30 cases (43%) cases. There was no significant change regarding both the angle of rotation and the amount of pleural effusion between the findings of the second and first year after the operation. The QRS shift was significantly more pronounced in patients with left pneumonectomies than right pneumonectomies. On echocardiography these cases showed right ventricular hypertrophy and increased pulmonary artery pressures in the second year when compared to the preoperative period. Conclusions: The current study showed that many significant changes occurred in the electrocardiographic and echocardiographic parameters of the heart after pneumonectomy

Vancomycin versus Linezolid in the Treatment of Methicillin-Resistant Staphylococcus aureus Meningitis

Abstract Background: Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the treatment of MRSA meningitis. Methods: We extracted data and outcomes for all adult patients (age > 18 years) with culture-proved MRSA meningitis who received vancomycin or linezolid between January 2006 and June 2011. A definite diagnosis of meningitis was based on the isolation of MRSA in at least one cerebrospinal fluid (CSF) culture and findings in CSF that are typical of the infection. Linezolid was given intravenously (IV) at a dosage of 600 mg q12h and vancomycin IV at 500 mg q6h. Results: A total of 8 patients with MRSA meningitis (5 male, 3 female; age [mean -SD] 61.6 -13.2 years) received vancomycin and 9 patients (7 male, 2 female; age 59.1 -15.6 years) received linezolid. All isolated strains of MRSA were susceptible to both vancomycin and linezolid. The rates of microbiologic success with linezolid or vancomycin, in terms of clearance of MRSA from CSF on day 5, were 7/9 and 2/8 (p = 0.044, Fisher exact test). No severe adverse events occurred in either treatment arm of the study. One-month survival of the patients in whom treatment was successful microbiologically was 2/2 in the vancomycin-treated group and 4/7 in the linezolidtreated group. Minimum inhibitory concentration (MIC) data for vancomycin were available for 5/6 treatment failures with vancomycin, and vancomycin MIC values of these five strains were 2 mg/L. Conclusion: Analysis of the findings in the limited cohorts in our study suggests that linezolid is superior to vancomycin for treating MRSA meningitis, especially in cases in which there is a high MIC (2 mg/L) for vancomycin. A clinical study involving larger cohorts may increase the evidence available in relation to this question

Neonatal tetanus in Turkey; what has changed in the last decade?

dikici, bunyamin/0000-0001-7572-6525WOS: 000259222800001PubMed: 18713452Background: Neonatal tetanus (NT) is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw attention to factors that may contribute (or may have contributed) to the elimination of the disease in Diyarbakir. Methods: The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results: A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA), and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8%) of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusion: Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination

The effect of different extenders on the sperm motility and viability of frozen Turkey semen

WOS: 000400881900007This study was conducted to develop long-term storage methods for turkey semen using different extenders. During the study, the massage method was used twice a week to collect the semen from five turkeys, a total of 44 times. The collected fresh semen's average ejaculate quantity, sperm concentration, motility and vitality values were determined as 0.22 +/- 0.01 ml, 3.5 +/- 0.17 x10(9) sp/ml, 77.0 +/- 1.44% and 86.2 +/- 0.95 % respectively. In this study, glucose (G) including 5% Dimethyl sulphoxide (DMSO) cryoprotective, tris-glucose (TG), lactated Ringer's (LR), and lactated Ringer's glucose (LRG) extenders were used. The Turkey semen was combined and divided into four equal parts, and subsequently diluted at a ratio of 1:3 and equilibrated at +4(circle)C for 90 minutes. Following equilibration, the samples were frozen in liquid nitrogen vapor to 80(circle)C for five minutes, and stored at -196(circle)C in liquid nitrogen. After freezing and thawing, the highest motility value was obtained from the G extender (43.3%+/- 1.62%) followed by LRG (24.6 +/- 1.53%), LR (12.6 +/- 0.92%) and TG (12.2 +/- 0.66%). The vitality values were recorded as 55.8 +/- 1.89%, 23.8 +/- 1.58%, 21.5 +/- 1.10% and 36.5 +/- 1.59% respectively. The motility and vitality values were significantly (p<0.01) more for the glucose extender than those for'other extenders. Therefore, it was concluded that glucose extender is better option for the long-term storage of Turkey semen.Ahi Evran UniversityAhi Evran University [PYO-ZRT.4003/2.13.006]; Ahi Evran University Scientific Research Projects Coordination DepartmentThis study was funded by Ahi Evran University with project number PYO-ZRT.4003/2.13.006. The authors are grateful to Ahi Evran University Scientific Research Projects Coordination Department for financial support and Veterinarian D. Ergun for his contribution to the manuscript

Intravaginal misoprostol alone versus intravaginal misoprostol and extraamniotic Foley catheter for second trimester pregnancy termination: an observational study

Background: No systematic empirical research exists addressing the question of optimal pregnancy termination method in second trimester pregnancies. Objectives: The purpose of this study was to determine the efficacy and safety of intravaginal misoprostol and extraamniotic Foley catheter combination for second trimester pregnancy termination. Methods: A single center, observational study was conducted in a total of 91 pregnancies. Women who met the termination of pregnancy criteria due to feto-maternal indications between 13 to 26 gestational weeks were included into the study. Study participants received intravaginal misoprostol in combination with Foley catheter (n=46) or intravaginal misoprostol alone (n=45). Results: The efficacy of intravaginal misoprostol and Foley catheter insertion combination was comparable to that of intravaginal misoprostol alone in terms of time to abortion/birth [median (95% Confidential Interval [95% CI]): 14.33 (11.33-17.25) hours and 12.08 (9.50-15.33) hours, respectively. Hazard Ratio: 0.73, 95% CI: 0.47 to 1.12, p= 0.14 (log-rank)]. The only serious maternal event was uterine rupture observed in one woman in Foley combination group. Conclusion: The combination of intravaginal misoprostol and extraamniotic Foley catheter for second trimester pregnancy termination does not provide additional efficacy

IgG4-related retroperitoneal fibrosis mimicking renal pelvis tumor: a case report and literature review

Abstract Background Retroperitoneal fibrosis (RPF) is a rare disease characterized by the development of a fibroinflammatory mass in the retroperitoneum. Immunoglobulin-G4 related RPF was suggested as a secondary form of RPF and thought to be part of the spectrum of Immunoglobulin-G4 related diseases (IgG4-RD). Patients often present to the clinic because of flank pain. Ranging from mild to end-stage renal failure can be observed. The main purpose of treatment is to preserve renal function. As it is a rare condition, there is no definite treatment strategy. We report a case of 39-year-old man with left flank pain and diagnosis of IgG4-related RPF mimicking a renal pelvis tumor. Case presentation A 39-year-old male patient presented with left flank pain. MRI suggested solid retroperitoneal mass associated with hydronephrosis in the left kidney collecting system. Upon identifying the retroperitoneal origin of the mass during nephroureterectomy, the procedure was concluded following the acquisition of frozen section and routine pathological samples from the lesion. In the histopathological examination, inflammatory cells were observed and specific immunohistochemistry for IgG-4 was detected focally positive. Following the placement of a DJ stent, immunosuppressive therapy was initiated with Prednol and Azathioprine. After a one-year follow-up period, during which the patient received immunosuppressive treatment and underwent tri-monthly DJ stent replacements, the DJ stent was subsequently removed, revealing complete regression of hydronephrosis. Conclusions With the correct diagnosis and treatment of IgG4-related RPF, it is possible to prevent irreversible complications of the disease. Because it is a rare disease, case reports in the literature will be useful for treatment

The effect of COVID-19 on tourists' attitudes and travel intentions: an empirical study on camping/glamping tourism in Turkey during COVID-19

Purpose - In this study, visitors' attitudes and behavioural intentions towards camping/glamping tourism in Turkey during the pandemic were investigated using the extended theory of planned behaviour (TPB). The model has been extended to include constructs such as risk perception and risk aversion attitudes that stem from COVID-19 to predict visitors' attitudes and behavioural intentions. Design/methodology/approach - The data were collected through an online questionnaire from 432 participants who have experience and interest in camping/glamping tourism in Turkey. The responses were analysed using the structural equation modelling (SEM). Findings - The findings show that besides the basic TPB structures, other added variables also significantly affect visitors' attitudes and intentions. Moreover, it has been observed that the risk perception and risk aversion attitude derived from COVID-19 increase negative emotions in visitors and decreased behavioural intentions. Research limitations/implications - The results of the study are discussed for future research as well as its academic and practical implications. Originality/value - This theoretical expansion is thought to increase the theory's predictive power in predicting visitors' behaviour during the pandemic