Pathophysiological Function of Adamts Enzymes on Molecular Mechanism of Alzheimer's Disease

The extracellular matrix (ECM) is an environment that has various enzymes attended in regeneration and restoration processes which is very important to sustain physiological and biological functions of central nervous system (CNS). One of the participating enzyme systems in ECM turnover is matrix metalloproteinases. A disintegrin-like and metalloproteinase with thrombospondin type 1 motifs (ADAMTS) is a unique family of ECM proteases found in mammals. Components of this family may be distinguished from the ADAM (A Disintegrin and Metalloproteinase) family based on the multiple copies of thrombospondin 1-like repeats. The considerable role of the ADAMTS in the CNS continues to develop. Evidences indicate that ADAMTS play an important role in neuroplasticity as well as nervous system pathologies such as Alzheimer's disease (AD). It is hopeful and possible that ADAMTS family members may be utilized to develop therapies for CNS pathologies, ischemic injuries, neurodegenerative and neurological diseases. To understand and provide definitive data on ADAMTS to improve structural and functional recovery in CNS injury and diseases, this review aimed to enlighten the subject extensively to reach certain information on metalloproteinases and related molecules/enzymes. It will be interesting to examine how ADAMTS expression and action would affect the initiation/progression of above-mentioned clinical situations, especially AD.WoSScopu

Carbon Monoxide Poisoning Cases Autopsied in South Marmara Region

Carbonmonoxide (CO) related deaths, which are generally preventable accidents that include accidents due to the coal stoves and water heaters in bath at home, the mining accidents, and other accidents. CO accept as the most common cause of poisoning cases in many countries and its prominent feature is being a colorless, odorless and nonirritant gas. In the period from 2007 until the end of 2011, the autopsy records of the ........ of Turkey were reviewed. Over a period of 5 years a total of 5782 autopsies were done of which 218 involved CO poisoning, constituting 3,8 % of total cases. Information regarding age, sex, month, year, and as well as various aspects were examined. Study data were encoded with computer and Statistical analysis was performed using SPSS for windows program. Of the cases 76 were (34,9%) female, 142 were (65,1%) male and male/female ratio was 1,9. Of the cases average age was 46.8, range between 1 and 90 years. 57,8% of deaths were in winter markedly. The highest carboxyhemoglobin saturation was 92% in the blood. Poisoning due to CO leaks from coal heaters is an important problem in our country and surrounding regions. The mining accidents should be reduced by increasing safety in the workplace. We must more expend efforts to educate the public and prevent CO poisoning. Key words: Carbon monoxide, poisoning, autopsy

Medicolegal Evaluation of Elderly Trauma Patients

Objective: The human body loses flexibility and durability from the pathophysiological changes of aging; therefore, trauma and the risk of injury increase in geriatric individuals. Elderly patients who have been admitted to health centers with trauma and injury require a serious treatment approach. Materials and Methods: A total of 15851 victims who were admitted to Bursa Branch of the Council of Forensic Medicine of the Ministry of Justice between 01/01/2011 and 31/12/2011 were retrospectively evaluated, and 207 of them, who were trauma patients aged 65 years and over, were included in this study. All cases were evaluated according to the cause of the injury, localization of the trauma, bone fractures and type of medical treatment. Results: Two hundred nineteen of the total 15851 forensic patients were 65 years and older. Of these 219 cases, 207 (94.5%) had been exposed to trauma. Of these 207 cases, 138 (66.7%) were male, and 69 (33.3%) were female. The most common types of trauma were physical assault (n=136) and motor vehicle accidents (n=56), which occurred at rates of 65.7% and 27.1%, respectively. For the trauma victims, head injury was the most commonly affected body region. Ninety-seven patients were treated conservatively (46.9%), and 43 patients were treated surgically (20.8%). Traumatic bone injury (31%) was detected in 64 patients. Conclusion: The results of our study indicate that most of the geriatric victims were admitted to the medical centers with traumatic causes. Thus, it is necessary to increase our social sensitivity to trauma and the ways in can be prevented in the geriatric age group. Key words: Trauma; Geriatric; Forensic case; Injury

The Role Of Adamts1 And Versican In Human Myocardial Infarction: A Postmortem Study

Objective: To determine the role of a disintegrin and metalloproteinase with thrombospondin type 1 motif (ADAMTS1) and fragmented versican in the myocardial infarction (MI) process in humans and to evaluate the diagnostic efficacy of ADAMTS1 for postmortem diagnosis of MI. Methods: Thirty autopsied individuals were allocated into 2 groups, namely, a study group of individuals who died of myocardial infarction (n = 20), and a control group who died of trauma (n = 10). We performed standard immunohistochemical staining on myocardial tissue specimens, studying anti-ADAMTS1, anti-versican, and anti-versican C terminal peptide sequence (DPEAAE) fragments. Results: Strong, diffuse staining was observed throughout myocardial tissue for ADAMTS1 in the 2 groups. However, in the study group, we observed no expression for ADAMTS1 around fibrotic areas but detected slight staining in coagulative and necrotic zones. Conclusion: Similar localizations of ADAMTS and fragmented versican in human heart tissue indicate that versican presumably is cleaved by ADAMTS1. Hence, ADAMTS1 can be regarded as a new marker for postmortem differential diagnosis of MI.WoSScopu

Middle-term outcomes in renal transplant recipients with COVID-19: a national, multicenter, controlled study

Background In this study, we evaluated 3-month clinical outcomes of kidney transplant recipients (KTR) recovering from COVID-19 and compared them with a control group. Method The primary endpoint was death in the third month. Secondary endpoints were ongoing respiratory symptoms, need for home oxygen therapy, rehospitalization for any reason, lower respiratory tract infection, urinary tract infection, biopsy-proven acute rejection, venous/arterial thromboembolic event, cytomegalovirus (CMV) infection/disease and BK viruria/viremia at 3 months. Results A total of 944 KTR from 29 different centers were included in this study (523 patients in the COVID-19 group; 421 patients in the control group). The mean age was 46 +/- 12 years (interquartile range 37-55) and 532 (56.4%) of them were male. Total number of deaths was 8 [7 (1.3%) in COVID-19 group, 1 (0.2%) in control group; P = 0.082]. The proportion of patients with ongoing respiratory symptoms [43 (8.2%) versus 4 (1.0%); P Conclusion The prevalence of ongoing respiratory symptoms increased in the first 3 months post-COVID in KTRs who have recovered from COVID-19, but mortality was not significantly different

The longitudinal evolution of post-COVID-19 outcomes among hemodialysis patients in Turkey

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients

The longitudinal evolution of post–COVID-19 outcomes among hemodialysis patients: A nationwide multicentre controlled study

BACKGROUND AND AIMS: Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD: We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS: A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients;15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION: In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. (Table Presented)