The Causes of Acute Fever Requiring Hospitalization in Geriatric Patients: Comparison of Infectious and Noninfectious Etiology

Introduction. Infectious diseases may present with atypical presentations in the geriatric patients. While fever is an important finding of infections, it may also be a sign of noninfectious etiology. Methods. Geriatric patients who were hospitalized for acute fever in our infectious diseases unit were included. Acute fever was defined as presentation within the first week of fever above 37.3°C. Results. 185 patients were included (82 males and 103 females). Mean age was 69.7 ± 7.5 years. The cause of fever was an infectious disease in 135 and noninfectious disease in 32 and unknown in 18 of the patients. The most common infectious etiologies were respiratory tract infections (n = 46), urinary tract infections (n = 26), and skin and soft tissue infections (n = 23). Noninfectious causes of fever were rheumatic diseases (n = 8), solid tumors (n = 7), hematological diseases (n = 10), and vasculitis (n = 7). A noninfectious cause of fever was present in one patient with no underlying diseases and in 31 of 130 patients with underlying diseases. Conclusion. Geriatric patients with no underlying diseases generally had infectious causes of fever while noninfectious causes were responsible from fever in an important proportion of patients with underlying diseases

Synthesis, antimicrobial and antiproliferative activities of new self-assembly benzimidazole-bridged aren ruthenium rectangles in human breast cancer cells

Some novel benzimidazole-bridged aren ruthenium rectangle compounds of the general structure [{Ru-2(p-cymene)(2)(mu(4)-OO boolean AND OO)}(2)(mu(4)-bbim)](4+) (bbim = 1,1 '-butyl-2-ene-di(benzimidazole) were obtained from the corresponding double-nuclear arene ruthenium compounds [Ru-2(p-cymene)(2)(mu(4)-OO boolean AND OO)Cl-2] (OO boolean AND OO = 2,5-dioxido-1,4-benzoquinonato (dobq), 2,5-dichloro-1,4-benzoquinonato (dClbq), 2,5-dibromo-1,4-benzoquinonato (dBrbq), oxalato (oxa), and 5,8-dioxido-1,4-naphtoquinonato (donq) via reaction with the bbim molecule and AgCF3SO3. The antiproliferative activity and anti-cancer properties of the tetranuclear arene ruthenium compounds were evaluated against the human breast cancer cell line (MDA-231-MB). Compound 2 showed the highest antiproliferative effect among the compounds during 24- and 48-h administration. In addition, all other compounds exhibited very good cancer cell selectivity and very low micromolar cytotoxicity. The antimicrobial activities of the synthesized compounds were also determined against various test microorganisms. Evaluations were carried out using the disk diffusion method and the dilution method. In particular, the compounds exhibited more potential antibacterial effects against Gram negative bacteria than against Gram positive bacteria and showed a superior antifungal effect against Candida species. The results revealed the benzimidazole-bridged aren ruthenium rectangle compounds to be very strong and potent inhibitors.Scientific Research Projects Unit of Duzce UniversityDuzce University [2017.05.03.600, 2017.05.03.620]This study was supported by the Scientific Research Projects Unit of Duzce University (Project Number: 2017.05.03.600 and 2017.05.03.620).WOS:0006906961000012-s2.0-8511381087

Efficacy of anakinra treatment in a patient with colchicine-resistant familial Mediterranean fever

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by self-limited recurrent attacks of fever and serositis. The serious complication of FMF is AA-type amyloidosis, which can result in end-stage renal disease. Although colchicine is effective in the majority of patients, there is no established treatment for those who are resistant or intolerant to colchicine. We herein report the efficacy of anakinra in a 52-year-old Turkish patient with FMF, secondary amyloidosis and renal transplant, who was resistant to colchicine treatment

Thrombotic thrombocytopenic purpura associated with multiple myeloma

Thrombotic thrombocytopenic purpura is a thrombotic microangiopathic disease. Associations with collagen vascular diseases, pregnancy, some drugs, surgical intervention, and infections are documented (known). Malignancy is also one of the known factors associated with thrombotic thrombocytopenic purpura. These malignancies are usually the disseminated solid organ tumors. Hematological malignancies constitute a rare association. Here, we present a patient with thrombotic thrombocytopenic purpura associated with multiple myeloma and discuss the pathogenesis. To our knowledge, this is the first case report of thrombotic thrombocytopenic purpura associated with multiple myeloma

A CASE OF HYPERRENINEMIC HYPERTENSION WITH ANORMAL RENALARTERY ANGIOGRAPHY DESPITE POSITIVE CAPTOPRIL RENOGRAPHYAND RENAL VEIN SAMPLING

Though biochemical findings appear to be similar to high-renin essential hypertension, hyperreninemic hypertension consists of a few diseases resulting in secondary hypertension. In this case with hyperreninemic hypertension, despite normal renal arterial angiography, captopril renography and renal vein sampling were found positive. We also discussed the difficulties in evaluating these tests in differential diagnosis

Hemophagocytic Syndrome Associated with Immune Reconstitution Inflammatory Syndrome in a Patient with AIDS Related Burkitt’s Leukemia/Lymphoma

Highly active antiretroviral therapy (HAART) has markedly decreased human immunodeficiency virus- (HIV-) related mortality and the incidence of opportunistic infections. The dramatic reduction in HIV-1 RNA and increase in CD4 lymphocyte count mean a recovery in immune function. This restoration in immune function may be associated with paradoxical deterioration in subclinical opportunistic infections in some patients, a condition called immune reconstitution inflammatory syndrome (IRIS). IRIS, a “paradoxical” inflammatory response to either previously treated or subclinical infections or noninfectious diseases, can manifest during the restoration phase of immunity hemophagocytic syndrome (HS) which is a very rare complication in patients with acquired immune deficiency syndrome (AIDS). We describe a case of hemophagocytic syndrome associated with IRIS in a patient with AIDS related Burkitt’s leukemia/lymphoma (BL). IRIS was probably the cause of hemophagocytosis for our patient. Zoster infection may facilitate to IRIS. With the increasing number of people with HIV infection and the accompanying use of HAART, much more clinical manifestations of IRIS will be experienced especially in patients given high dose chemotherapy, just like in our case