Hakan GÖKER ,
Elifcan ALADAĞ ,
Haluk DEMİROĞLU ,
Cağlayan AYAZ ,
Yahya BÜYÜKAŞIK ,
Ahmet İNKAYA ,
Salih AKSU ,
Nilgün SAYINALP ,
İbrahim HAZNEDAROĞLU ,
Ömrüm UZUN ,
Murat AKOVA ,
Osman ÖZCEBE ,
Serhat ÜNAL
COVID-19 (Coronavirus disease of 2019) is an infectious disease outbreak later on declared as a pandemic, caused
by the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). It spreads very rapidly and can result in severe acute respiratory
failure. The clinical studies have shown that advanced age and chronic diseases increase the risk of infection. However, influence of the
blood groups on COVID-19 infection and its outcome remains to be confirmed. The aim of this study is to investigate whether there
exists a relationship between the blood groups of the patients and risk of SARS-CoV-2 infection and the clinical outcomes in COVID-19
patients.
Material and method: 186 patients with PCR confirmed diagnosis of COVID-19 were included in this study. Age, sex, blood groups,
comorbidities, need for intubation and intensive care unit follow up and mortalities of the patients were analyzed retrospectively. 1881
healthy individuals, who presented to the Hacettepe University Blood Bank served as the controls.
Results: The most frequently detected blood group was blood group A (57%) amongst the COVID-19 patients. This was followed by
blood group O (24.8%). The blood group types did not affect the clinical outcomes. The blood group A was statistically significantly
more frequent among those infected with COVID-19 compared to controls (57% vs. 38%, P < 0.001; OR: 2.1). On the other hand, the
frequency of blood group O was significantly lower in the COVID-19 patients, compared to the control group (24.8% vs. 37.2%, P: 0.001;
OR: 1.8).
Conclusions: The results of the present study suggest that while the blood group A might have a role in increased susceptibility to the
COVID-19 infection, the blood group O might be somewhat protective. However, once infected, blood group type does not seem to
influence clinical outcome.
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Hamad DHEIR, Savaş SİPAHİ, Selçuk YAYLACI, Mehmet KÖROĞLU, Ali Fuat ERDEM, Oğuz KARABAY
Hamad DHEIR, Savaş SİPAHİ, Selçuk YAYLACI, Mehmet KÖROĞLU, Ali Fuat ERDEM, Oğuz KARABAY
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Background/aim: To compare the clinical use, image quality and viewing angle of a commonly used contact wide angle viewing (WAV)
system (Advanced Visual Instruments (AVI) Panoramic Imaging Systems, NY, USA) with a commonly used noncontact WAV system
(Leica RUV800, Leica Microsystems, Switzerland).
Materials and methods: Images of 42 consecutively operated eyes were obtained with both systems at the same surgical stages and were
compared for image quality using the Imatest Master 4.5.13 (Imatest LLC, Boulder, USA) software. The viewing angles of the images
were calculated using the optic disc sizes measured from the OCT and infrared fundus images. The 68-degree AVI lens was compared
with the 90-dioptre (D) Leica RUV800 lens, while the 130-degree AVI lens was compared with the 132-D Leica RUV800 lens. The
surgical assistants were asked to grade the difficulty of holding the lens in place from 1 to 10, 1 being the easiest and 10 being the most
difficult.
Results: The contact system provided wider viewing angles with higher quality compared to the noncontact system both under fluid and
air media. The difference was clinically significant in eyes with impaired corneal clarity, very high myopia, or small pupil. The difficulty
of holding the lens in place ranged from 4 to 7, and decreased gradually with practice.
Conclusions: Both WAV systems provided high image quality and adequate viewing angles in most cases. However, the contact system
appeared to provide a superior image quality and/or a wider viewing angle in more challenging situations. The difficulty of holding the
contact lens in place was found to be moderate.
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Aida MAHDAVI ,
Nadereh RASHTCHIZADEH ,
Hadise KAVANDI ,
Mehrzad HAJIALILO ,
Sousan KOLAHI ,
Mohammad NAKHJAVANI ,
Ali asghar EBRAHIMI ,
Seyedmostafa SEYEDMARDANI ,
Mansour SALESI ,
Mohsen SOROUSH ,
Alireza KHABBAZI
Background/aim: This study aimed to evaluate the demographic, clinical, angiographic and prognostic characteristics of Takayasu
arteritis (TA) in Iran.
Materials and methods: A total of 75 patients with TA based on the American College of Rheumatology 1990 criteria for TA
classification referred to the Rheumatology Centres, were followed-up from 1989 to 2019. Demographic, clinical, angiographic and
prognostic characteristics were collected at baseline and last visit.
Results: The mean age was 31.9 ± 9.8 years at the disease onset. Female to male ratio was 14. The median latency in diagnosis was 24
months. Pulse discrepancy in the arms, blood pressure discrepancy in the arms, limb claudication, hypertension and constitutional
symptoms were the most common clinical features. The most common angiographic type at the time of diagnosis was Type I (42.7%).
The most frequent arterial lesion was stenosis (89.4%). Subclavian, carotid and aortic arteries were the most commonly involved arteries.
New lesions developed in 28.6% of patients during the 5.25-year follow-up. Vasculitis-induced chronic damage was observed in all
patients. Disease activity decreased and vascular damage remained stable throughout the follow-up period.
Conclusions: The clinical features and angiographic type of TA in Iran are different from most Asian countries. Differences in
angiographic and clinical features may lead to delayed diagnosis. The issue of delay in diagnosis should create awareness among health
care providers that TA is not a very rare disease in Iranians and failure to pay attention to warning symptoms may delay the diagnosis.
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Background/aim: Rapid antigen test (RAT) is a practical test to detect the presence of Group A beta hemolytic streptococcus antigens
in throat swab samples. The aim of this study is to investigate the changes in the empiric antibiotic prescribing behavior of 10 family
physicians in Kırıkkale Province after using RAT in 2017.
Materials and methods: RAT test practice started in Family Medicine in February 2017. Family Medicine Information System (FMIS)
includes clinical and prescription records of 10 family physicians, providing health service to approximately 35,000 residents in
Kırıkkale. The numbers of antibiotics prescribed by the physicians according to the ICD-10 codes (including upper respiratory tract
infections) in February, March, and April of 2015, 2016, 2017 were determined. The number and group of antibiotics prescribed by the
family physicians with the determined diagnosis and time periods were specified in the FMIS and recorded.
Results: Antibiotic prescription behaviors of family physicians do not show a significant difference between 2015 and 2016. There was a
dramatic and significant decrease in the number of prescribed antibiotics in 2017 compared to 2015 and 2016 (P < 0.05).
Conclusion: This study shows that there has been a significant decrease in antibiotic prescription in 10 Family Medicine departments
in 2017 in comparison to February, March, and April 2015 and 2016. The use of RAT resulted in a decrease in antibiotic prescription
rates in 2017.
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Background/aim: Immune thrombocytopenia (ITP) is treated by corticosteroids and/or intravenous immune globulin as the first line
treatment when necessary. Mean platelet volume (MPV) is a marker of platelet production and function. In this study, we aimed to
search the relationship between the MPV and the treatment response in ITP patients and it was hypothesized that MPV can be used as
a predictor of the response.
Materials and methods: The 70 newly diagnosed adult primary ITP patients and 70 of healthy people were included. MPV between ITP
and healthy population, MPV in the diagnosis and after the treatment between the responders and the nonresponders were compared.
Results: The responders had significantly higher MPV and the nonresponders had significantly lower MPV than the healthy population
(11.09 and 10.21 fL, P = 0.03; 9.38 and 10.21 fL, P = 0.001). MPV in the diagnosis was significantly higher in the responders than the
nonresponders (11.09 and 9.38 fL, P = 0.005). MPV significantly changed after the treatment in the responders (11.09 to 9.32 fL, P =
0.004).
Conclusion: MPV can be used as a predictor of early response to the first line treatment in newly diagnosed adult primary ITP patients.
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Background/aim: Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterized by dry skin, pruritus and eczematous
lesions. The aim of this study is to evaluate the skin moisture and sebum content of the infants with AD and its relationship between the
disease severity.
Materials and methods: For this cross-sectional and case-control study we included 49 infants with AD aged between 2 and 24 months
and 34 healthy infants with the same age and sex as a control group. Skin moisture and sebum content were measured by the bioimpedance method and recorded. Skin prick tests, total IgE levels and food-specific (milk, egg) IgE levels were performed.
Results: There was a significant difference between the groups in terms of mean skin moisture and sebum content percentage (P < 0.001,
both). The mean skin moisture and sebum content were correlated with CRP in patients with AD (P < 0.01, r = –1.00, both), but we did
not find any correlation between these parameters with the disease severity.
Conclusion: We found that skin moisture and sebum content were low even in unaffected areas in AD. The skin structure of these
patients may contribute to the pathogenesis of the disease.
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Background/aim: Previous studies reported that patients with chronic low back pain (CLBP) had trouble describing senses or body
functions. A questionnaire, the body awareness rating questionnaire (BARQ), was recently developed for assessing body awareness.
The aim of the study was to develop a Turkish version of the BARQ and investigate the validity and reliability in patients with CLBP.
Materials and methods: BARQ translated to Turkish with forward-backward method. Ninety-nine patients with CLBP and 101 healthy
controls (HC) completed the BARQ-T. Fifty-one of patients with CLBP and HC repeated BARQ-T 3 days later. In addition to BARQ-T,
Oswestry disability index (ODI), pain severity, short form 36 (SF-36) and Toronto alexithymia scale (TAS) were administered.
Results: The current study found good-excellent Cronbach’s alpha values for patients with CLBP (α: between 0.883–0.967) and
acceptable-good Cronbach’s alpha values for HC (α: between 0.649–0.825) in factors of BARQ-T. ICC values for test-retest validity were
found to be good-excellent for patients with CLBP in all factors. BARQ-T was positively correlated with SF-36 and negatively correlated
with ODI and TAS (P < 0.05).
Conclusion: The study confirmed that the BARQ-T has acceptable validation and reliability in terms of pain perception and pain
assessment in the Turkish CLBP community.
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Background/aim: FloTrac/Vigileo is a noncalibrated arterial pressure waveform analysis for cardiac index (CI) monitoring. The aim of
our study was to compare the CI measured by the 4th generation of FloTrac with PiCCO in septic shock patients.
Materials and methods: We simultaneously measured the CI using FloTrac (CIv) and compared it with the CI derived from
transpulmonary thermodilution (CItd) as well as the pulse contour-derived CI using PiCCO (CIp).
Results: Thirty-one septic shock patients were included. The CIv correlated with CItd (r = 0.62, P < 0.0001). The Bland-Altman analysis
showed a bias of 0.14, and the limits of agreement were –1.62–1.91 L/min/m2
with a percentage error of 47.4%. However, the concordance
rate between CIv and CItd was 93.6%. The comparison of CIv with CIp (n = 352 paired measurements) revealed a bias of -0.16, and the
limits of agreement were –1.45–1.79 L/min/m2
with a percentage error of 44.8%. The overall correlation coefficient between CIv and CIp
was 0.63 (P < 0.0001), and the concordance rate was 85.4%.
Conclusion: The 4th generation of FloTrac has not acceptable agreement to assess CI; however, it has the ability to tracked changes of
CI, when compared with the transpulmonary thermodilution method by PiCCO.
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Background/aim: Adipokines play an important role in the regulation of metabolism. In critical illness, they alter serum levels and are
suspected to worsen clinical outcomes. But the effect of the route of nutrition on adipokines is not known. The purpose of this study
was to evaluate the association between the route of nutrition and adipokine levels in critically ill patients.
Materials and methods: This prospective study was performed in an intensive care unit (ICU). Patients admitted to the ICU for least
72 h and receiving either enteral nutrition (EN) via tube feeding or parenteral nutrition (PN) were enrolled. Serum was obtained at
baseline, 24 h, and 72 h for concentrations of leptin, adiponectin, resistin, glucagon–like peptide 1 (GLP–1), insulin–like growth factors
1 (IGF–1), and ghrelin.
Results: A total of 26 patients were included in the study. Thirteen patients received EN and 13 patients received PN. In the PN group,
leptin level significantly increased (P = 0.037), adiponectin and ghrelin significantly decreased during follow up (P = 0.037, P = 0.008,
respectively). There was no significant change between all adipokines in the EN group and resistin, IGF–1 and GLP–1 in the PN group
during follow up. Resistin levels were markedly lower in the EN group at both 24 h (P = 0.015) and 72 h (P = 0.006) while GLP–1 levels
were higher in the EN group at baseline, 24 h, and 72 h (P = 0.018, P = 0.005, and P = 0.003, respectively). There were no differences in
leptin, adiponectin, IGF–1, and ghrelin levels over time.
Conclusion: The delivery of EN in critical illness was associated with decreased resistin levels and increased GLP–1 levels. Thus, the
route of nutrition may impact the clinical outcome in critical illness due to adipokines.
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