Abstract Objective The aim of the present study was to evaluate the diagnostic value of soluble triggering receptor on myeloid cells-1 as a novel marker for diagnosis of childhood urinary tract infections (UTI). Methods This study enrolled 30 pediatric patients diagnosed with acute febrile UTIs; 30 healthy children were included as the control group. The blood samples from the patients and healthy controls were collected for a soluble triggering receptor on myeloid cells-1 (sTREM-1) test. Results The study group was composed of 9 males and 21 females, and the mean age of the study population was 6.6 ± 3.2 (range = 1–14) years. sTREM-1 levels were significantly higher in UTI patients than in the controls (592 ± 323 vs. 490 ± 299 pg/mL, p = 0.04). The receiver operating curve analysis revealed a cut-off value of soluble triggering receptor expressed on myeloid cells-1 of 514 ng/mL (area under the curve = 0.562). When the cut-off value was taken 514 pg/mL, soluble triggering receptor expressed on myeloid cells-1 had a sensitivity of 57% and a specificity of 50% for the diagnosis of UTI. Conclusion The present study revealed that plasma sTREM-1 level may be elevated in UTI and may therefore serve as a useful predictive tool for the diagnosis of UTI.
Twenty cases of pylon fractures were treated with IIizarov circular external fixators using the technique of ligamentotaxis. Fourteen men and six women, ranging in age from 20 to 59 years, with open or closed distal tibial fractures were included in this study. The fractures were classified according to the AO system and distributed as seven C1, eight C2, and five C3 fractures. Independent from the type of fracture, six were grade II open according to the Gustilo-Anderson classification. For all fractures, an external fixator was constructed, after reduction by traction and olive wires. Mean follow-up was 29 months. All fractures healed by 14 weeks postreduction. The results were assessed using Weber's criteria: 5 (25%) had excellent results, 10 (50%) good, and 5 (25%) poor results. This technique lowers the rated complications of open reduction and internal fixation, and allows restoration of joint-surfaces, reconstruction of length, and alignment of the extremity while maintaining a sufficient range of motion at the joint. We concluded that use of the Ilizarov circular external fixator enables good results in selected ankle traumas when applied with good indications, planning, and surgical experience.
Global Influenza Hospital Surveillance Network is a worldwide initiative that aims to document the burden of influenza infections among acute admissions and vaccine effectiveness in particular countries. As a partner of this platform, we aimed to determine the frequency of influenza infections among acute admissions with influenza-like illness and the outcomes of enrolled patients during the 2015-2016 influenza season in selected hospitals in Turkey.The investigators screened the hospital admission registries, chart review or available records, and screened all patients hospitalized in the previous 24-48 hours or overnight in the predefined wards or emergency room. A total of 1351 patients were screened for enrollment in five tertiary care referral hospitals in Ankara and 774 patients (57.3% of the initial screened population) were eligible for swabbing. All of the eligible patients who consented were swabbed and tested for influenza with real-time polymerase chain reaction (PCR) based methods.Overall, influenza positivity was detected in 142 patients (18.4%). The predominant influenza strain was A H1N1pdm09. Outcomes were worse among elderly patients, regardless of the presence of the influenza virus. Half of the patients over 65 years of age were admitted to the intensive care unit, while one third required any mode of mechanical ventilation and one fourth died in the hospital in that particular episode.These findings can guide hospitals to plan and prepare for the influenza season. Effective influenza vaccination strategies, particularly aimed at the elderly and adults with chronic diseases, can provide an opportunity for prevention of deaths due to influenza-like illness.
Objective: We evaluated PCR negativity in oropharyngeal and nasopharyngeal secretions of COVID-19 patients at the end of hydroxychloroquine and/or favipiravir treatments. Methods: Study inclusion criteria were being hospitalized, being older than 18 years, PCR positivity in oropharyngeal and nasopharyngeal secretions and being tested for SARS CoV-2-RNA PCR after treatment. Initially hydroxychloroquine treatment (group 1) was administered to the patients according to COVID-19 guide of Health Ministry. Favipiravir (group 2) alone or in combination with hydroxychloroquine (group 3) was administered to patients who were unresponsive to hydroxychloroquine or had severe pneumonia or were admitted to intensive care unit. Control respiratory specimens were taken no earlier than 24 hours, after the end of therapy. Repeated tests with 24–48-hour intervals were performed in patients with still positive PCR test results. The detection of SARS CoV-2-RNA was made by real-time PCR. Results: The study group included 492 patients who received treatment. Mean duration of symptoms was similar among three groups. PCR negativity rate was 52.8% in the specimens taken 24 hours after the end of treatment. PCR negativity rates was 27.9% (200/492) in 48 hours after the end of treatment, %13.8 (123/492) in 72nd hour and %3.8 (80/492) in 96th hour. The ratios of PCR negativity for all specimen days were similar in three groups. There was no statistically significant difference between the groups for time to PCR negativity from the date of positivity and after the end of treatment. We determined that early or late treatment did not make a difference in terms PCR negativity time. Conclusion: No difference was found in terms of the ratios of PCR negativity or time for negativity in oropharyngeal and/or nasopharyngeal specimens taken after the end of treatment in COVID-19 patients receiving hydroxychloroquine and/or favipiravir treatment.
Aim: COVID-19 is an important public health problem in world and Turkey. The present study aimed to compare the clinical and laboratory findings and mortality rates among vaccinated and unvaccinated COVID-19 inpatients.Material and Method: We included patients receiving inpatient treatment in COVID-19 wards of our hospital between April 25 and October 22, 2021. The patients were divided into two groups: those with and without the COVID-19 vaccine. We extracted patient information from anamnesis files and the hospital information system. Then, we recorded the patients’ epidemiological and laboratory findings and vaccination status. Patients with at least two doses of the COVID-19 vaccine were considered “vaccinated.” We performed Fisher’s exact test and Chi-square test to analyze the data. All statistical analyses were performed in SPSS, and a p-value <0.05 was accepted as statistically significant.Results: The study included 63 vaccinated and 83 unvaccinated patients. With a mean age of 71.4±12.3 years, thirty (47.6%) of the vaccinated patients were females, and 33 (52.3%) were males. Of the unvaccinated ones, 40 (48.1%) were females, while 43 (51.8%) were males (mean age=52.2±14.4 years). The mean age was significantly higher in the vaccinated group than in the unvaccinated group (p<0.01). While 82.5% of the vaccinated patients received two doses, 17.5% received three doses of the COVID vaccine. Besides, 95.3% of the patients received their first dose of inactivated vaccine (Sinovac, China) and 4.7% of an mRNA vaccine (BioNTech, Germany). We found that comorbidities were significantly more prevalent in the vaccinated group than in the unvaccinated group (44 (69.8%) vaccinated and 34 (40.9%) unvaccinated patients had a comorbid disease, p<0.01). Among the accompanying diseases, hypertension was significantly more prevalent in the vaccinated group than in the unvaccinated group (p<0.01). Considering their laboratory findings, the vaccinated patients had significantly higher leukocyte, troponin, and ferritin values than the unvaccinated patients (p=0.008). Consequently, five (57.9) of the vaccinated patients and 4 (4.8%) of the unvaccinated patients died (p=0.05). Conclusion: Similar mortality rates between our vaccinated and unvaccinated patients may be attributed to the fact that the vaccinated group was relatively older, had more comorbid diseases, and received their second dose after an average of 100.6 days following their first dose of inactivated vaccine. In conclusion, further clinical research involving more cases that received different COVID-19 vaccines is needed to uncover the factors affecting mortality and morbidity among vaccinated patients.
Aim: The literature seems to miss the clinical course of COVID-19 infection among the pregnant and its effects on the fetus. The present study aimed to evaluate a total of 21 pregnant inpatients in Ankara Training and Research Hospital with the diagnosis of COVID-19 in terms of symptoms, physical examination findings, laboratory findings, treatment results, and complications. Material and Method: A total of 21 pregnant patients diagnosed with COVID-19 by reverse transcriptase polymerase chain reaction (RT-PCR) in Ankara Training and Research Hospital between 22.04.2020 and 27.09.2021 were included in the study. The clinical symptoms, physical examination findings, laboratory findings, and treatment outcomes of the patients, and the health status of the pregnant and newborn were retrospectively evaluated. Results: Of the 21 pregnant patients, 10 were Turkish citizens, and 11 were foreign nationals. The patients were aged 20-41 years with a mean age of 28.76 years. All patients were unvaccinated. Considering underlying diseases among the patients, it was found that one patient had hypertension, and one patient had thyroid disease. In order of frequency, the symptoms in the patients were cough (n =10), fatigue (n=8), sore throat (n=6), dyspnea (n=5), fever (n=3), myalgia (n=3), joint pain (n=1), and diarrhea (n=1). Physical examinations of the patients yielded a fever of 37.4 °C above in 3 patients and rales in one patient. Although one patient with COVID-19 pneumonia was followed up in the intensive care unit, all were discharged upon recovery. Chloroquine tablets were started in 6 patients, a combination of ritonavir (50 mg) and lopinavir (200 mg) in 4 patients, and favipiravir in one patient. Cesarean section was performed in 9 patients, while 12 patients gave normal delivery. Conclusion: Overall, the clinical course of COVID-19 infection in the pregnant followed up in this study was mild, and all newborns were healthy except for one. It is thought that close follow-ups for the pregnant are needed to minimize complications that may develop in them and their fetuses due to COVID-19 infection. Finally, the COVID-19 vaccine seems to be a must for the pregnant to prevent all possible COVID-related complications.
The os supranaviculare is an accessory bone located on the dorsal aspect of the talonavicular joint close to the midpoint. This rare incidental skeletal variant has an estimated prevalence of 1%. It may rarely become symptomatic and should not be confused with cortical avulsion fractures of navicular or talar head. We present the case of a 25-year-old professional basketball player with pain on the dorsum of his right foot after twisting his ankle during a regular season match. Magnetic resonance imaging findings of the player's foot represented a flake of bone on the superior part of the talar head. The differential diagnosis and clinical outcome of this unusual case are briefly discussed.
Background/aim: The localization of the standard posterior portal of shoulder arthroscopy and landmarks mentioned in the literature are unclear. The purpose of this prospective cadaveric study was to determine the localization of the standard posterior portal and its distance to the neural structures. Materials and methods: One fresh frozen and 10 formalin-fixed adult cadaveric shoulders were dissected. In the beach chair position, a 5-mm trocar was placed anteroposteriorly from the superior edge of the subscapularis muscle, superior to the tip of the coracoid process and tangent to the glenoid. The relevant distances of the posterior exit point were measured. Results: In all specimens, the exit point was a triangular fibrous area, between the posterior and lateral parts of the deltoid. Medial and inferior distances of the trocar to the posterolateral tip of the acromion were 1.88 ± 0.53 cm and 1.35 ± 0.34 cm and distances to the axillary and suprascapular nerves were 4.54 ± 1.08 cm and 2.54 ± 0.85 cm, respectively. Conclusion: The most important finding of this study was the superficial localization of the soft spot between the posterior and lateral parts of deltoid.
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