Chlamydia trachomatis is one of the most common causative agents of sexually transmitted diseases. The authors studied the occurrence of C. trachomatis in the semen of 184 asymptomatic men participating in the IVF programme. Twenty-six (14.1%) of the 184 tested were positive for C. trachomatis, these patients and their wives receiving doxycycline capsules twice, 100 mg on the first day and 100 mg/day for the following 13 days. This treatment was effective in 88.5% of the cases and in the rest, treatment continued with erithromycin 250 mg four times/day for 2 weeks. The authors compared the semen parameters (cell count, motility, morphology, bovine mucus penetration and hypo-osmotic swelling test) in the infected and non-infected groups and observed no significant difference between these two groups.

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Introduction: The objective of the D-dimer tests is to exclude venous thromboembolic disorders. The characteristics of various D-dimer tests differ significantly and consequently, their results are difficult to compare. Aim: Our goal was to compare three D-dimer tests, analyse their correlation and harmonise their sensitivity and specificity through the optimisation of cut-off values. Method: At Semmelweis University, the D-dimer level was determined with three different reagents in 158 plasma samples, suspected with venous thromboembolism. INNOVANCE D-Dimer was selected as the referent, and in the case of the two other tests (STA-Liatest D-Di; Dia-D-Dimer), the cut-off values were changed between 0.2–1 µg/ml (fibrinogen-equivalent unit – FEU). The optimal cut-off values were estimated by diagnostic parameters and chi-square test. The correlation of the different tests was calculated by regression analysis. Results: Based on the chi-square statistics, there is no significant difference between STA-Liatest D-Di and INNOVANCE D-Dimer tests using the cut-off values 0.3–1 µg/ml (FEU) (STA-Liatest D-Di). In the case of Dia-D-DIMER, there is a significant difference using 0.2–0.3 µg/ml (FEU) cut-off values, 0.4 µg/ml (FEU) is a border-line value and using 0.5–1 µg/ml (FEU) cut-off values, there is no significant difference. The sensitivity of STA-Liatest D-Di changed between 82.7–100% using 0.2–1 µg/ml (FEU) cut-off values, while the sensitivity of Dia-D-DIMER was 92.3–100%. Their specificities ranged between 50–96.3% and 35.2–87%. The optimal cut-off values were estimated as 0.5–0.6 µg/ml (FEU) for the STA-Liatest D-Di test and 0.7 µg/ml (FEU) for the Dia-D-DIMER test. Conclusion: Each diagnostic laboratory should determine the optimal cut-off value of the D-dimer test in use, considering the examined population of the area. Orv Hetil. 2019; 160(15): 585–592.

Absztrakt: Bevezetés: A COVID–19 kórlefolyásában újabban több szerző felvetette a D-dimer-pozitivitás és a D-dimer-emelkedés prediktív értékét a betegség súlyosbodásában, illetve az eseti halálozásban. Célkitűzés: Magyar betegek értékeinek összehasonlítása a nemzetközi adatokkal, ennek részeként a D-dimer prediktív értéke a 2 héten belüli eseti halálozásra. Módszerek: A szerzők 51, RT-PCR-rel igazolt SARS-CoV-2-fertőzött beteg D-dimer-eredményeit dolgozták fel retrospektív módon. Megvizsgáltuk, hogy ha a D-dimer eléri vagy meghaladja a vágóérték 4-szeresét, akkor ez milyen kockázatot (odds ratio) jelent a halálozásra. Logisztikus regresszióval meghatároztuk, hogy a 2 héten belüli halálozás esélyhányadosa a konvencionális vágóérték hányszorosa mellett lesz szignifikáns. Eredmények: Az 51 betegből 13 halt meg a kórházba kerülést követően 2 héten belül. Megállapítottuk, hogy a tradicionális, 0,5 µg/ml FEU vágóérték mellett meghatározott D-dimer-pozitivitásnak alacsony a prediktív értéke a halálozásra. Ha azt vizsgáltuk, hogy a D-dimer eléri vagy meghaladja a vágóérték 4-szeresét, és ez milyen kockázatot jelent a halálozás szempontjából, akkor a logisztikus regresszió paraméterei 1,64-szeres emelkedést mutattak (p = 0,00183), és az esélyhányados (odds ratio) értéke 5,17 (CI 95% = 1,32–20,22) volt. A D-dimer prediktív értéke a halálozásra az életkor függvényében változik. A 13 elhunyt közül 12 idősebb volt 80 évesnél, így a 80 év feletti életkor a magas D-dimer-szintnél nagyobb kockázatot jelentett a halálozásra, odds ratio: 20,7 (CI 95% = 2,41–175,5). Következtetés: A több mint négyszeres vágóértékre emelkedett D-dimer-szint az életkor mellett COVID–19-ben előre jelezheti a 2 héten belüli halálozást. Orv Hetil. 2020; 161(41): 1739–1743.

Background : Our objectives were to investigate the incidence of elevated methemoglobin level among COVID-19 patients at intensive care unit. The correlation of methaemoglobinemia with mortality and some haematological parameters was also tested. Methods: The diagosis of coronavirus -19 infection was confirmed by RT-PCR. The quantitative method for determination of methemoglobin was it’s cyanide derivative by spectrophotometry. The reference range was less than 2 percent. Results: There were altogether 46 patients (11 male, 35 female) included. Their median age value was 70 y. ( 29 – 89). The methemoglobin median value was 4,3%. 15 of 46 patients died. The methemoglobin median value of departed patients was 8 % , and 2,5% was among survivors. ( P= 0,001) 19 patients were blood transfused. Their methemoglobin median was 11 % , otherwise the non transfused patients presented 2,7 % methemoglobin median. ( p= 0,001). We performed two binary logistic regression calculation, in order to judge the elevated methemoglobin level as an independent risk factor for the mortality. The predictor of methaemoglobin was 0,062 the constant -1,266 the odds ratio 1,06. The other binary logistic regression tested the fact of transfusion for the mortality. Predictor of transfusion 1,1474, constant -1,2527 odds ratio 3,15 There was no significant correlation between methemoglobin and CRP level. Discussion: The methemoglobin is not able to transport oxygen. It’s association with mortality is discussed by some papers.There are several hypothesis in the literature to explain it’s occurrence in COVID-19. The role of coronavirus proteins as oxydative agents was mentioned. The importance of enzyme defect is emphasized. The impact of reactive oxygen free radicals in inflammation is also probable. Some papers mentioned applying local anesthetics and azythromycin as a risk. The role of transfusion is obscure, because the methemoglobin can be elevated in blood conserves during storage. Conclusion: Testing the methemoglobin seems to be important, but the pathomechanism needs further research.. The traceability and standardization of different measurement methods at intensive care units is the key for defining it’s pathogenetic role.