Spontaneous pneumomediastinum incidence and clinical features in non-intubated patients with COVID-19

OBJECTIVES: To evaluate the presentation characteristics and disease course of seven patients with COVID-19 who spontaneously developed pneumomediastinum without a history of mechanical ventilation.METHODS: A total of seven non-intubated patients with COVID-19, of age ranging from 18-67 years, who developed spontaneous pneumomediastinum between 01 April and 01 October 2020 were included in the study. Patients’ demographic data, clinical variables, and laboratory values were examined. Spontaneous pneumomediastinum was evaluated using posteroanterior chest radiography and thorax computed tomography.RESULTS: During the research period, 38,492 patients reported to the emergency department of our hospital with COVID-19 symptoms. Of these, spontaneous pneumomediastinum was detected in seven patients who had no previous history of intubation. Chronic obstructive pulmonary disease (2/7) and asthma bronchiale (2/7) were determined as the most common causes of comorbidity.CONCLUSION: In our study, the frequency of spontaneous pneumomediastinum developing without pneumothorax was found to be high in non-intubated patients. Whether this is related to the nature of the disease or it is a result of the increase in cases diagnosed incidentally owing to the increasing use of low-dose computed tomography should be explored in further studies

The Role of 18F-Flourodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in Pelvic and Paraaortic Lymph Node Staging of Uterine Cervical Cancer

 Abstract: Aim: We aimed to evaluate the sensitivity of 18F-Flourodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the detection of pelvic and paraaortic lymph node metastases of uterine cervical cancer.Material and Method: 32 female patients (mean age: 56.1±12.6) who underwent 18F-FDG PET/CT for preoperative staging of uterine cervical cancer between April 2009 and October 2013 were included to the study. Ethical committee approval was taken from Ankara University Medical Faculty Ethics Committee. All the patients had been performed trans-vaginal examination and diagnosed as uterine cervical cancer before 18F-FDG PET/CT. 18F-FDG PET/CT findings were compared with histopathological examination results. Sensitivity, specificity and accuracy of pelvic MRI and 18F-FDG PET/CT were calculated in the detection of pelvic and paraaortic lymph node metastases.Results: 18F-FDG uptake was seen in primary cervical lesions of all the patients. Mean SUV max of primary cervical lesions was calculated as 13.6±6.6 (range: 6.7-25). In 16 (50%) patients, 18F-FDG uptake was not seen in pelvic and paraaortic lymph nodes. In the remaining patients, 18F-FDG uptake was detected in pelvic nodes in all the patients (50%) and in paraaortic nodes in 6 (18%) patients. Mean SUV max of pelvic lymph nodes were calculated as 8.4±5.2 and of paraaortic lymph nodes 12.45±6.41. 18F-FDG uptake was detected in a total of 47 lymph node stations in 16 patients. Mean SUVmax of all lymph nodes were calculated as 8.9±5.83 (range: 2.6-21.9). According to 18F-FDG PET/CT findings, disease was upstaged from I to IV in 1 (3%) patient, II to III in 2 (6%) patients, III to IV in 1 (3%) patients and I to III in 2 (6%) patients, and down staged from III to I in 1 (3%) patient, respectively. In the patient-based analysis, 18F-FDG PET/CT was TP, TN, FP and FN in 14 (%44), 14 (44%), 2 (6%) and 2 (6%) patients, respectively. Patients based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 87%, 87% and 87%, respectively. In the lesion-based analysis, 18F-FDG PET/CT was TP, FP, TN and FN in 30, 7, 37 and 5 lymph node stations, respectively. Lesion based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 85%, 84% and 84%, respectively.Conclusion: 18F-FDG PET/CT is a reliable imaging tool with its high sensitivity and specificity in the pelvic and paraaortic lymph node staging of uterine cervical cancer. When performed in the preoperative staging it changes disease stage about in ¼ of patients. In combination of pelvic MRI, primary staging of primary cervical lesions and also pelvic/paraaortic lymph nodes can be done successfully

The Role of 18F-Flourodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in Pelvic and Paraaortic Lymph Node Staging of Uterine Cervical Cancer

Aim: We aimed to evaluate the sensitivity of 18F-Flourodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the detection of pelvic and paraaortic lymph node metastases of uterine cervical cancer.  Material and Method: 32 female patients (mean age: 56.1±12.6) who underwent 18F-FDG PET/CT for preoperative staging of uterine cervical cancer between April 2009 and October 2013 were included to the study. Ethical committee approval was taken from Ankara University Medical Faculty Ethics Committee. All the patients had been performed trans-vaginal examination and diagnosed as uterine cervical cancer before 18F-FDG PET/CT. 18F-FDG PET/CT findings were compared with histopathological examination results. Sensitivity, specificity and accuracy of pelvic MRI and 18F-FDG PET/CT were calculated in the detection of pelvic and paraaortic lymph node metastases.  Results: 18F-FDG uptake was seen in primary cervical lesions of all the patients. Mean SUV max of primary cervical lesions was calculated as 13.6±6.6 (range: 6.7-25). In 16 (50%) patients, 18F-FDG uptake was not seen in pelvic and paraaortic lymph nodes. In the remaining patients, 18F-FDG uptake was detected in pelvic nodes in all the patients (50%) and in paraaortic nodes in 6 (18%) patients. Mean SUV max of pelvic lymph nodes were calculated as 8.4±5.2 and of paraaortic lymph nodes 12.45±6.41. 18F-FDG uptake was detected in a total of 47 lymph node stations in 16 patients. Mean SUVmax of all lymph nodes were calculated as 8.9±5.83 (range: 2.6-21.9). According to 18F-FDG PET/CT findings, disease was upstaged from I to IV in 1 (3%) patient, II to III in 2 (6%) patients, III to IV in 1 (3%) patients and I to III in 2 (6%) patients, and down staged from III to I in 1 (3%) patient, respectively. In the patient-based analysis, 18F-FDG PET/CT was TP, TN, FP and FN in 14 (%44), 14 (44%), 2 (6%) and 2 (6%) patients, respectively. Patients based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 87%, 87% and 87%, respectively. In the lesion-based analysis, 18F-FDG PET/CT was TP, FP, TN and FN in 30, 7, 37 and 5 lymph node stations, respectively. Lesion based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 85%, 84% and 84%, respectively.  Conclusion: 18F-FDG PET/CT is a reliable imaging tool with its high sensitivity and specificity in the pelvic and paraaortic lymph node staging of uterine cervical cancer. When performed in the preoperative staging it changes disease stage about in ¼ of patients. In combination of pelvic MRI, primary staging of primary cervical lesions and also pelvic/paraaortic lymph nodes can be done successfully

Investigation of Immunogenicity and Protective Efficiency of Bordetella Bronchiseptica Fimbriae in Mice

Fimbrial proteins are important for adhesion and colonization of Bordetella bronchiseptica in the upper respiratory tract. In this study, determination of immunogenicity of the fimbrial proteins isolated from different strains of B. bronchiseptica and their protective efficacy against fetal challenge was aimed. For this purpose, fimbrial proteins of seven standard strains and clinical isolates of B. bronchiseptica were partially purified by gel filtration chromatography and analysed by SDS-PAGE. In microagglutination test, whole cell F415 was used as the antigen and the agglutination of sera from mice immunized with the purified fimbrial proteins was observed at titers of 1:128 for strains 219 and 4617 and the isolate CA; 1:256 for strain F415 and the isolate UK7; 1:512 for the isolate UK6 and 1:4096 for strain 3036. In addition, by ELISA against F415 fimbrial antigen, the antifimbriae antibody levels of the immune mouse sera were observed at serum dilutions of 1:6400 for UK7; 1:3200 for UK6, F415 and 3036; 1:1600 for CA; 1:800 for 219 and 1:400 for 4617. The protective values of the fimbrial proteins against fetal challenge with strain F415 in mice immunized with the fimbrial proteins (2x25 mu g/dose) were; 100% for F415 and 3036, 84% for UK6 and 50% liar UK7, but no protection was observed with the other strains and isolates. In conclusion, fimbrial antigens were determined to have important protective efficacy and anti-fimbriae antibody levels were found correlated with that protective efficacy.Wo

Innovation And Relationships In Industrial Districts: The Case Of Turkey

Industrial districts (ID) and small scale industrial estates are important regional development tools that have been extensively utilized by the Turkish authorities as part of Turkish industrialization programs, with varying degrees of success. The empirical part of the study is carried out one of the oldest industrial zone in Turkey, Ankara (Sincan). Following the determination of innovative capacity of the firms, the study investigates the intra- and inter-ID firm relationships, and its possible implications for firm level innovation activity. In the first stage of this study, the purpose is to explore vertical I/O (input-output) inter-firm links. Following the relationship mapping, a background structure is obtained for supply chains and the relative focal firm positions are observed. For this end, a survey is employed to 207 firms. The analysis of cross-tabulations provides valuable insights in the relationship between innovative capacity of firms and their interactions with the environment. According to a latest formal report, four firms from the district are placed among the 500 largest firms in Turkey. The results of the study will further give evidence for developing Turkish ID innovation policies.Interfirm relations, innovation, industrial district, Turkey.

Use of Multivariate Statistics Methods to Determine Grain Size, Heavy Metal Distribution and Origins of Heavy Metals in Mersin Bay (Eastern Mediterranean) Coastal Sediments

WOS: 000317245800075The aim of the study was to determine variability, heavy Metal Content and potential origins of heavy metals of the sediments in a total of 60 locations representing coastal sediments of Mersin Bay,Grain size distribution and heavy metal contents were measured and multivariate statistical analyses were performed on obtained Values in grain size distribution, Oz-4, 5, 6, 11, 12, 13, 14, 15, 16, 18, 19, 22 23, 46, 48, 49, 50 Stations showed a bimodal distribution. This distribution developed due to river networks near the locations. Heavy metals are sequenced as Cr, Mn, Sr, Ni, V, Zn, Co, Zr, Rb, Ce, Cu, Sc, Li, Y, Pb, As, Nb, Mg, Fe, Al, Th and U from the higher value to the lower value according to their abundance: According to frequency histogram, Ni, Fe, Al, which showed the highest concentration values among heavy metals came from short medium distance; while Cr, Ti and Mn came from short distance. Based on these findings it should be thought,that heavy Metal sources affecting Study area are in short distances to study area All the elements were represented with three sector principal component analysis. Total variances of Pb, As, U, Th, Sb, P, La, Ba, Na, K, W, Ce, Li and Rb elements which represent (F1) factor were explained by 30.591 %. Variance of Mn, Fe, V, Ti, Al, Zr, Y, Sc and Hf elements which represent (F2) factor were explained by 18.749'%. Total Variance of Mo, U, Sr, Ca, P, Ti, Nb and Ta elements which represent the third factor (F3) were explained by 14.512 %. These data are significantly consistent with the dendongram prepared according to coefitic correlation coefficients. Hierarchical group analysis dendorigram showed that Q-type cluster had a 50 % arbitrary Similarity level and that contamination generally occurred in group 3. It can be thought that similar groups had the same properties during contamination. In regression data performed according to Fe; "Model summary" (according to R-2 = 99.8 value) was Significantly adequate for Statistical data and "Anova". was highly reliable with 36 explanatory Variables. Heavy metals in the study area such as Cr, Mn, Ni, Zn, Co, Cu, Pb, Mg, Al, Cd, Sb and Ti might show toxic effects. Heavy metals, such as As, Ag, Fe, Mo And Sn should also be paid attention. Al, Fe, Ti, Mn, Cr, Ni, Co, Pb, Zn and V showed an anomaly according to Kizkalesi and Susanoglu coastal sand. Cr, Ni, Co, Mg, Ti, Fe and Mn increased due to Mersin Ophiolite. The areas where basie/ultrabasic rocks outcropped in the region can be considered as the source of natural contaminations. Anthropogenic factors, coastal sediments, coastal erosion and lithological effects are the main causes of contamination in the study area, which covers a very wide area. In addition, the port, river entrances, highway, urban wastes, tourist facilities and industrial sites increased the density of anthropogenic effect.Scientific Research Projects Unit of Akdeniz UniversityThis study contains a part of Master of Science thesis and Scientific Research Projects of Nigde University prepared by Ozlem CEVIK. The financial support of the Scientific Research Projects Unit of Akdeniz University is gratefully acknowledged