The relationship of age and previous BCG vaccination with tuberculin skin test (TST) reactivity was investigated to assess the interpretation of TST results in the adult population of Turkey, where there is a high prevalence of tuberculosis and a routine BCG vaccination programme. The influences of age and BCG vaccine status on booster reaction were also evaluated. TST was applied (5 tuberculin units of purified protein derivative intradermally) to two healthy adult groups, namely 98 medical students and 187 elderly people in a retirement home. The TST was considered positive if an induration > or = 10 mm in diameter was produced. Subjects (41 elderly people and 39 students) with a reaction < 10 mm in diameter were retested 1 week later. There was no significant difference between the students (59.1%) and elderly subjects (58.8%) with respect to positive TST response. No influence of BCG scars on TST reactivity was observed in either group. The booster effect was seen more commonly in the elderly, but the presence of a BCG scar did not influence the booster effect in either group. It was concluded that a positive TST response and booster reaction in adults in high-prevalence countries may be caused by latent tuberculosis rather than previous vaccination.
Objective: To evaluate emergency peripartum hysterectomy (EPH) cases over a 14-year period in a tertiary center in İstanbul, Turkey. Material and Methods:In this retrospective descriptive study, the records of all cases of EPH performed at the Zeynep Kamil Women and Keywords: Postpartum hemorrhage, placenta accreta, emergency peripartum hysterectomy, trend Received: 26 November, 2015 Accepted: 18 January, 2016 Changing trends in emergency peripartum hysterectomy in a tertiary obstetric center in Turkey during [2000][2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011][2012][2013] Osman
Purpose Cytokines are major mediators of COVID-19 pathogenesis and several of them are already being regarded as predictive markers for the clinical course and outcome of COVID-19 cases. A major pitfall of many COVID-19 cytokine studies is the lack of a benchmark sampling timing. Since cytokines and their relative change during an infectious disease course is quite dynamic, we evaluated the predictive value of serially measured cytokines for COVID-19 cases. Methods In this single-center, prospective study, a broad spectrum of cytokines were determined by multiplex ELISA assay in samples collected at admission and at the third day of hospitalization. Appropriateness of cytokine levels in predicting mortality were assessed by receiver-operating characteristic (ROC) analyses for both sampling times in paralel to conventional biomarkers. Results At both sampling points, higher levels of IL-6, IL-7, IL-10, IL-15, IL-27 IP-10, MCP-1, and GCSF were found to be more predictive for mortality (p<0.05). Some of these cytokines, such as IL-6, IL-10, IL-7 and GCSF, had higher sensitivity and specificity in predicting mortality. AUC values of IL-6, IL-10, IL-7 and GCSF were 0.85 (0.65 to 0.92), 0.88 (0.73 to 0.96), 0.80 (0.63 to 0.91) and 0.86 (0.70 to 0.95), respectively at hospital admission. Compared to hospital admission, on the 3rd day of hospitalization serum levels of IL-6 and, IL-10 decreased significantly in the survivor group, unlike the non-survivor group (IL-6, p = 0.015, and IL-10, p = 0.016). Conclusion Our study results suggest that single-sample-based cytokine analyzes can be misleading and that cytokine levels measured serially at different sampling times provide a more precise and accurate estimate for the outcome of COVID-19 patients.
Objective Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. Method A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p < 0.01 and p < 0.05 were considered statistically significant. Results While maternal age and gravidity were similar in both groups (p > 0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p < 0.05). The reduction in hemoglobin level, rate of complications, and number of transfusions were similar in both groups (p > 0.05). Conclusion This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.
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