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COVID-19 in kidney transplant recipients: A multicenter experience in Istanbul
No full textPubMed: 32657540Introduction: Management of COVID-19 in kidney transplant recipients should include treatment of the infection, regulation of immunosuppression, and supportive therapy. However, there is no consensus on this issue yet. This study aimed to our experiences with kidney transplant recipients diagnosed with COVID-19. Material and Methods: Kidney transplant recipients diagnosed with COVID-19 from five major transplant centers in Istanbul, Turkey, were included in this retrospective cohort study. Patients were classified as having moderate or severe pneumonia for the analysis. the primary endpoint was all-cause mortality. the secondary endpoints were acute kidney injury, the average length of hospital stay, admission to intensive care, and mechanical ventilation. Results: Forty patients were reviewed retrospectively over a follow-up period of 32 days after being diagnosed with COVID-19. Cough, fever, and dyspnea were the most frequent symptoms in all patients. the frequency of previous induction and rejection therapy was significantly higher in the group with severe pneumonia compared to the moderate pneumonia group. None of the patients using cyclosporine A developed severe pneumonia. Five patients died during follow-up in the intensive care unit. None of the patients developed graft loss during follow-up. Discussion: COVID-19 has been seen to more commonly cause moderate or severe pneumonia in kidney transplant recipients. Immunosuppression should be carefully reduced in these patients. Induction therapy with lymphocyte-depleting agents should be carefully avoided in kidney transplant recipients during the pandemic period. © 2020 Wiley Periodicals LLCIstanbul ÜniversitesiI would like to mention those healthcare professionals who have been victims of COVID-19 in Turkey. in Turkey, 7428 health workers have been infected and some of these individuals have died from the disease. in particular, I wish to commemorate our teacher, Professor Murat Dilmener, and Cemil Tas??o?lu, both of whom died of COVID-19. Both spent many years working as clinicians and teachers at Istanbul University. We remember them with respect and appreciation
Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study
No full textMondello, Stefania/0000-0002-8587-3614; Alizada, Orkhan/0000-0003-0942-9906; Ghorbani, Mohammad/0000-0002-7709-3095; Abedi, Vida/0000-0001-7689-933XWOS: 000575454600010PubMed: 32818804Background: There is an increased attention to stroke following SARS-CoV-2. the goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients. Methods: This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). the outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. the counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. the risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. the study was reported according to the STROBE, MOOSE, and EQUATOR guidelines. Findings: We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke-123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. the need for mechanical ventilation (OR: 1.9, 95% CI:1.1-3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4-4.7, p = 0.006) were predictive of stroke. Interpretation: the results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). the need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients. (C) 2020 the Authors. Published by Elsevier B.V
The treatment effect on peripheral B cell markers in antibody positive myasthenia gravis patients
No full textPubMed: 32977248B cells play a major role in the pathophysiology of myasthenia gravis (MG) with their ability to produce disease specific, pathogenic antibodies. However, their status during disease development and follow-up stages of the disease in the peripheral blood may need further studies to determine useful markers. in this study, we aimed to detect B cell associated factors concerning immunosuppressive treatment in generalized non-thymomatous MG patients. Although CD19+ B cell distribution did not vary among disease subgroups, expressions of both CD38 and BAFFR were altered on B cells in MG patients under immunosuppressive therapy. Serum levels of BAFF were elevated in untreated MG patients as compared to treated MG patients and healthy controls. B cell activation factors may show profound alterations due to immunosuppression. © 2020109S353, TUBITAK-106S223 21125 British Association for Psychopharmacology, BAPThis research was supported by the Turkish Scientific Research Council ( TUBITAK-106S223 and 109S353 ), AFM-Telethon ( #21125 ) and Istanbul University Research Fund (BAP)
Positive heparin/pf4 antibodies and high mortality rate: A retrospective case-series analysis
No full textIntroduction: Heparin-induced thrombocytopenia (HIT) is a potentially lethal complication of unfractionated or low-molecular weight heparin therapy. We aimed to determine the incidence and mortality rate of patients with positive heparin/platelet factor 4 (PF4) antibodies, which is a rapid detection test of HIT. Methods: Coronary artery bypass grafting and mitral and aortic valve surgeries were evaluated. Cardiopulmonary bypass was employed in all patients. the diagnosis of HIT was based on immunological assays. Postoperative complications, mortality rates, and the causes of death were specified in patients with positive heparin/PF4 antibodies. Results: Postoperative thrombocytopenia was detected in 257 patients. Twenty of these patients undergoing open heart surgery were included in the final analysis. Antibodies against heparin/PF4 complex were positive in 20 patients. the mean body mass index was 28.8±2.3 kg/m², mean value of left ventricular ejection fraction was 48.3±6.7%, cardiopulmonary bypass time was 113.0±35.0 min, aortic cross-clamping time was 88.0±32.7 min, mean intensive care unit length of stay was 10.9±4.9 days, mean preoperative platelet count was 307.250±88528 platelets/microliter, and mean postoperative platelet count was 243.050±89.354 platelets/ microliter. the mean duration of heparin exposure was 6.9±2.9 days. the mortality rate was 45% (nine patients) and 1.2% (three patients) in heparin/PF4 complex positive and negative patients, respectively. Conclusion: Although the incidence of HIT was low in patients undergoing open heart surgery, an increased rate of early mortality was observed in patients with positive heparin/PF4 antibodies. © 2020, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved
Mutation of SGK3, a Novel Regulator of Renal Phosphate Transport, Causes Autosomal Dominant Hypophosphatemic Rickets
No full textCavalier, Etienne/0000-0003-0947-2226; Shi, Yufei/0000-0002-6999-0191WOS: 000553452200045PubMed: 31821448Context. Hypophosphatemic rickets (HR) is a group of rare hereditary renal phosphate wasting disorders caused by mutations in PHEX, FGF23, DMP1, ENPP1, CLCN5, SLC9A3R1, SLC34A1, or SLC34A3. Objective. A large kindred with 5 HR patients was recruited with dominant inheritance. the study was undertaken to investigate underlying genetic defects in HR patients. Design. Patients and their family members were initially analyzed for PHEX and FGF23 mutations using polymerase chain reaction sequencing and copy number analysis. Exome sequencing was subsequently performed to identify novel candidate genes. Results. PHEX and FGF23 mutations were not detected in the patients. No copy number variation was observed in the genome using CytoScan HD array analysis. Mutations in DMP1, ENPP1, CLCN5, SLC9A3R1, SLC34A1, or SLC34A3 were also not found by exome sequencing. A novel c.979-96 T>A mutation in the SGK3 gene was found to be strictly segregated in a heterozygous pattern in patients and was not present in normal family members. the mutation is located 1 bp downstream of a highly conserved adenosine branch point, resulted in exon 13 skipping and in-frame deletion of 29 amino acids, which is part of the protein kinase domain and contains a Thr-320 phosphorylation site that is required for its activation. Protein tertiary structure modelling showed significant structural change in the protein kinase domain following the deletion. Conclusions. the c.979-96 T>A splice mutation in the SGK3 gene causes exon 13 skipping and deletion of 29 amino acids in the protein kinase domain. the SGK3 mutation may cause autosomal dominant HR.KACST Biotech grant [13-MED1765-20]This study is supported by a KACST Biotech grant 13-MED1765-20
Protective effect of oxytocin on a methotrexate-induced ovarian toxicity model
No full textOzceltik, Gokay/0000-0003-1413-685XWOS: 000524622800003PubMed: 32266527Purpose Although cancer predominantly affects people at older ages, a substantial number of patients, like breast cancer patients, are diagnosed before they have completed their families or even before giving birth. Furthermore, cytotoxic chemotherapy may be required in addition to treat cancer survivors. the present study was conducted to investigate the protective effect of oxytocin (OT) on methotrexate (MTX)-induced ovarian toxicity in rats. Methods Eighteen adult female Sprague-Dawley rats were used in the study. All rats were divided randomly into three groups. the control group (n = 6) received no treatment. the remaining 12 rats received a single dose of 20 mg/kg of MTX. Half of the rats (n = 6) were treated with 1 mg/kg/day of saline, and the other half (n = 6) were treated with 160 mu g/kg/day of OT for 21 days. Then, blood samples were collected for biochemical analysis, and an ovariectomy was performed for histopathological examination. Results Plasma malondialdehyde (MDA) and transforming growth factor-beta (TGF-beta) levels were significantly lower in the MTX + OT group compared to the MTX + saline group (p = 0.000036 for MDA; p = 0.0044 for TGF-beta). AMH levels were also significantly higher in the MTX + OT group than in the MTX + saline group (p = 0.000036). the ovarian fibrosis percent was also notably lower in the MTX + OT group than in the MTX + saline group (p = 0.000036). Conclusion on the basis of these findings, OT is a promising agent for ameliorating harmful effects of MTX on rat ovaries in an experimental model
Oxygen Concentration’s Effects on Respiratory Mechanics During Recruitment Manoeuvre
No full textPubMed: 31485873[No abstract available
Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation
No full textFerah, Oya/0000-0001-5585-7368; Canbolat, Ismail Polat/0000-0002-2374-9693WOS: 000540633100004PubMed: 32519985Objective: the post-operative serum level of N-terminal pro-brain natriuretic peptide (NT-proBNP) has been found to be associated with post-operative cardiovascular complications and mortality in high-risk surgeries. the usefulness of the post-operative NT-proBNP level as a predictor of mortality after liver transplantation (LT) is unknown. Methods: the records of patients at a single, tertiary university hospital who had undergone adult living donor liver transplantation (LDLT) with data of post-operative NTproBNP level values were retrospectively analyzed for in-hospital mortality. the highest post-operative NT-proBNP level from the first 3 days after surgery was included in the study. Receiver operating characteristic curve analysis was performed to assess the best cut-off value of post-operative NT-proBNP, and Cox regression analysis was performed to investigate the effect of NT-proBNP on mortality. Results: A total of 114 LT recipients with a mean Model for End-Stage Liver Disease score of 15.8 were included in the study. In-hospital mortality occurred in 11 (9.6%) of the patients. A history of diabetes mellitus and the post-operative NT-proBNP level were found to be associated with mortality (p=0.011 for diabetes mellitus and p<0.001 for NT-proBNP). the best cut-off value of post-operative NTproBNP was 1009 ng/L. Cox regression analysis indicated that the NT-proBNP level was a strong predictor of in-hospital mortality (hazard ratio: 24.467, 95% confidence interval: 3.120-191.750; p=0.002). Conclusion: the post-operative NT-proBNP serum level independently predicted in-hospital mortality in patients who underwent LDLT. Post-operative NT-proBNP-guided management of LT recipients should be pursued
Sağlıklı Çocuklarda Mediastinal Lenf Ganglionları; Yaşa Göre Sıklık, Boyut Aralığı Ve Dağılım
No full textnodes (LN) is crucial. We elaborated the mediastinal LNs based on location, size and age groups. Material and Method: Contrast enhanced chest computed tomography scans of 150 children who were referred to the radiology department after trauma, were evaluated retrospectively. All participants were divided into five age groups (0-24, 25-60, 61- 120, 121-180 and 181-216 months) which included thirty children each. We documented the shortest and longest axis diameters of the largest LNs and their location along with the age and gender of the children. Kolmogorov-Smirnov test, t test, Spearman’s correlation analysis assessment and descriptive statistics were expressed using SPSS 22. Results: Mean ages were 11.53±10.1, 39.4±11.1, 84±15.9, 154.9±17.6, 190±9.3 months in consecutive age groups and 96±69.17 months in general. The most frequent locations with detectable LNs were subcarinal (n:98, 64%), right lower paratracheal (n:88, 57%), right tracheobronchial (n:82, 56%), right upper paratracheal (n:75, 49%) and left tracheobronchial (n:61, %39) lymphatic stations. Mean short and long axis diameters were 3.97±1mm (interquartile range:3.4-5.2) and 7.48±1.98mm (interquartile range:6.3-9.1) among detected 648 LNs, respectively. Both short and long axis diameters of LNs in low cervical, prevascular, subcarinal, right-left paratracheal and right-left tracheobronchial locations were correlated with the age (p<0.05). Both short and long axis diameters of subcarinal LNs (4.78±1.05mm, 9.30±1.8mm) were significantly larger than right lower paratracheal (4.03±0.9mm, 7.94±1.6mm; p:0.001), right tracheobronchial (4.42±1.26mm, 8.59±2.1mm; p:0.04) and right upper paratracheal LNs (3.64±0.79mm, 7.1±1.49mm). Conclusion: Being aware of the size range for normal mediastinal LNs according to ages and locations would facilitate management and reduce unnecessary interventions and medications.Amaç: Klinik olarak anlamlı lenf nodları (LN) hakkında karar vermek çok önemlidir. Mediastinal LNları lokasyon, boyut ve yaş gruplarına göre değerlendirdik. Gereç ve Yöntem: Travma sonrası radyoloji bölümüne yönlendirilen 150 çocuğun kontrastlı göğüs bilgisayarlı tomografi taramaları retrospektif olarak değerlendirildi. Tüm katılımcılar her biri otuz çocuğu içeren beş yaş grubuna ayrıldı (0-24, 25-60, 61-120, 121-180 ve 181-216 ay). En büyük LNlarının kısa ve uzun eksendeki çapları konumları, yaş ve cinsiyetlerine göre değerlendirildi. SPSS 22 programı ile Kolmogorov-Smirnov testi, t testi, Spearman korelasyon analizi ve tanımlayıcı istatistikler çalışıldı. Bulgular: Ortalama yaş, gruplarda sırasıyla 11,53±10,1 ay, 39,4±11,1 ay, 84±15,9 ay, 154,9±17,6 ay, 190±9,3 ay ve toplamda 96±69,17 aydı. LN’larının en sık görüldüğü lokasyonlar subkarinal (n:98, %64), sağ alt paratrakeal (n:88, %57), sağ trakeobronşiyal (n:82, %56), sağ üst paratrakeal (n:75, %49) ve sol trakeobronşiyal (n:61, % 39) lenfatik istasyonlardı. Ortalama kısa ve uzun eksen çapları sırasıyla 647 LN arasında 3.97±1mm (çeyrekler arası aralık: 3,4-5,2) ve 7,48±1,98mm (çeyrekler arası aralık: 6,3-9,1) idi. Alt servikal, prevasküler, subkarinal, sağ-sol paratrakeal ve sağ-sol trakeobronşiyal lokasyonlarda LNlarının hem kısa hem de uzun eksen çapları yaşla korele idi (p<0,05). Subkarinal LN’larının kısa ve uzun eksen çapları (4,78±1,05 mm, 9,30±1,8mm) sağ alt paratrakeal (4,03±0,9mm, 7,94±1,6mm; p:0,001), sağ trakeobronşiyal (4,42±1,26mm, 8,59±2,1mm; p:0,04) ve sağ üst paratrakeal LN’lerden (3,64±0,79mm, 7.1±1,49mm) anlamlı derecede büyüktü
The prevalence of performance-related musculoskeletal disorders in fine arts faculty students and academics
No full textWOS: 000565197700014PubMed: 32417820BACKGROUND: While professional musicians may have a high incidence of musculoskeletal pain, there are few studies on the performance-related musculoskeletal disorders (PRMD) in visual artists. OBJECTIVE: To assess the prevalence and probable risk factors of PRMD in visual artists. METHODS: the study population comprised the students and academics of fine arts faculty. the Rapid Entire Body Assessment (REBA) and the Cornell Musculoskeletal Discomfort Questionnaires were used to evaluate posture and pain, respectively. RESULTS: the study included 197 participants (140 women, 57 men). the mean REBA score was 5.2. the sculptors who worked in marble sculpting had the highest REBA scores. of the participants, 88.8% reported musculoskeletal pain. the pain severity of 64.0% of the participants was 3 (very uncomfortable with a reduction in activity) and/or 4 (pain interferes with the ability to work). the PRMD prevalence was 64.0%, and significantly higher in women than in men (p < 0.05). CONCLUSIONS: Musculoskeletal pain in visual artists is extremely prevalent. Mean REBA score of 5.2 corresponds to a medium risk assessment accompanied by guidance to "further investigate, change soon." the policy makers in fine arts faculties who are responsible for student and employee health should prioritize strategies to prevent and manage musculoskeletal pain