Association of ACE ID, MTHFR C677T, and MIF-173GC variants with the clinical course of COVID-19 patients

The course of coronavirus disease-2019 (COVID-19) differs from person to person. The relationship between the genetic variations of the host and the course of COVID-19 has been a matter of interest. In this study, we investigated whether Angiotensin-Converting Enzyme (ACE) ID, Methylenetetrahydrofolate Reductase (MTHFR) C677T, and Macrophage Migration Inhibitory Factor (MIF)-173GC variants are risk factors for the clinical course of COVID-19 disease in Turkish patients. One hundred COVID-19 patients were included in the study. The diagnosis of COVID-19 was made using Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Chest Computed Tomography (CT). The patients were evaluated in 3 groups: intensive care, service, and outpatient treatment. ACE ID, MTHFR C677T, and MIF-173GC variants were genotyped by PCR-Restriction Fragment Length Polymorphism (RFLP) methods. When the genotype distribution between the groups was examined, it was found that the frequency of the ACE DD genotype and the D allele was higher in the intensive care group compared to the hospitalized and outpatient groups. MTHFR C677T CT genotype T allele and MIF-173GC, CC genotype C allele were more prevalent in the intensive care group compared to other groups. Patients with PCR-positive results had a higher MTHFR C677T C/C genotype and C allele. In CT-positive patients, the MTHFR C677T CT genotype and the MIF-173GC, G allele were more common. It is predicted that genetic predisposition may contribute to COVID-19 morbidity and mortality. Our results show that ACE ID, MTHFR C677T, and MIF-173GC variants affect the course of COVID-19 disease in the Turkish population.

Comparison of Two Clinical Chemistry Analyzers by Total Analytical Error and Measurement Uncertainty

BACKGROUND

Although analytical errors contain a small portion of laboratory errors, they are important in terms of intervention ability and practicality of follow-up by laboratory professionals. Also, from this point of view, the test results' quality, reliability, and accuracy are crucial to laboratories. Therefore, to determine analytical performance parameters for quality management in the analytical phase, clinical laboratories utilize total analytical error (TAE), bias, coefficient of variation (CV), and uncertainty of measurement (MU).

METHODS

Fifteen biochemistry parameters were compared with Beckman Coulter AU 5800 for 2017 - 2018 and Roche Cobas 8000 for 2019 - 2020 in terms of TAE and MU. The results were evaluated between devices and compared with the EuBIVAS, CLIA, RCPA, PRDEQA%, pUQEAS%, pU%, and TEa-TR datasets.

RESULTS

There were no significant differences between the devices for the mentioned periods. Device performances resulted in similar outcomes. During our four-year study, nearly all of our tests failed for EuBIVAS, RCPA, and pU%. On the contrary, almost all of our parameters gave valid results according to the CLIA, PRDEQA%, pUQEAS%, and TEa-TR ranges.

CONCLUSIONS

It is crucial to distinguish between "mistake" and "uncertainty." The discrepancy between the measured value and the 'actual value' is called error. Uncertainty is a measure of how confident you are in the measurement outcome. We endeavor to remedy any known inaccuracies wherever feasible by applying adjustments from calibration certifications. On the other hand, any inaccuracy whose value is unknown is a cause of doubt.

Results of using Luer-Lok access device for clinics, intensive care units, and emergency services with high pre-analytical errors: analysis of 491.850 samples

Objectives

The effectiveness of the Luer-Lok™ Access Device (LL) with the intravenous catheter (IVC) on sample rejections, which is used to prevent primarily hemolysis in the emergency department (ED), clinics, and intensive care units (ICU), was examined.

Methods

A total of 491.850 samples of eight months from Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital were investigated retrospectively. Inpatient, intensive care unit and emergency department samples were included in the study. Pre- (BLL) and post-Luer Lok (ALL) rejection of the samples analyzed. In the BLL period, 3,463 rejection samples out of 253,818 (1.36%) in the September-December period of 2020; in the ALL period, 1819 rejected samples from 238,032 (0.76%) in January-April 2021 were analyzed for all reasons.

Results

It was determined that the use of LL significantly reduced all-cause sample rejections. In addition, a significant decrease was observed in the rates of hemolysis and clot-related rejection thanks to LL.

Conclusions

According to our study data, in patients with IVC with the LL device, the pressure brought by the syringe is mainly avoided, and reliable blood collection is achieved, similar to the routine vacutainer blood collection apparatus, and hemolysis- and clot-related sample rejections are largely prevented.

Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever

BACKGROUND & OBJECTIVES

Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease, caused by a tick-borne virus (Nairovirus), having a high mortality rate. The study was aimed to evaluate the risk factors, the presenting symptoms and findings of the patients with prediagnosis of CCHF disease, and to compare these variables between the CCHF-positive and CCHF-negative patients. It was also aimed to develop a scoring formula for the diagnosis of CCHF.

METHODS

In total, 281 patients who were admitted to the Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey between 2011 and 2015 and were prediagnosed with CCHF based on the clinical symptoms, laboratory findings and risk factors were included in the study. The definitive laboratory diagnosis of patients with prediagnosis of CCHF was ensured via molecular and serological methods. In addition, a mathematical diagnostic scoring formula was developed for enhancing the laboratory results of CCHF.

RESULTS

The ratio of certain clinical symptoms such as fever (p<0.001), headache (p<0.001), widespread body pain (p<0.001), fatigue (p = 0.001), nausea and vomiting (p = 0.013) in CCHF-positive patients were found to be significantly higher compared to the ratio in CCHF-negative patients. In terms of laboratory findings such as presence of leucopenia (p<0.001), creatine kinase (CK) elevation (p<0.001), thrombocytopenia (p<0.001), aspartate aminotransferase/alanine aminotransferase (AST/ALT) elevation (p<0.001), lactate dehydrogenase (LDH) levels (p = 0.002), absence of abnormal findings on chest radiograph (p = 0.042), and the absence of anaemia (p = 0.007), the CCHF-positive patients had higher rates in comparison to CCHF-negative ones.

INTERPRETATION & CONCLUSION

It was inferred that certain clinical symptoms and laboratory findings such as fever, headache, widespread body pain, fatigue, leucopenia, nausea, vomiting, high CK levels, thrombocytopenia, AST/ ALT elevation and elevated LDH levels are highly specific and are required to be considered in the definitive diagnosis of CCHF, particularly in regions where this infection is observed as endemic.

Resection and primary anastomosis with modified blow-hole colostomy or Hartmann's procedure. Which method should be performed for gangrenous sigmoid volvulus?

AIM

To evaluate the efficacy of Hartmann's procedure and RPA with modified blow-hole colostomy for gangrenous sigmoid volvulus.

METHODS

Sixty-one patients operated on between January 2004 to September 2010 were reviewed retrospectively. The demographic data of the patients,clinical features, type of surgical procedure performed, postoperative complications, mortality and duration of hospital stay (DHS) after surgery were reviewed.

RESULTS

The mean hospital stay, wound infection and mortality did not differ significantly between the groups. Superficial wound infection rate was higher in group A (32% vs15%). Development of leaks secondary to stoma closure was not observed in any patient. During hospitalisation period; the postoperative complications were wound infection in four patients, intraabdominal abscess in two, evisceration and wound dehiscence in two, arrhythmia in six, pneumonia in eight.Medical and surgical complication rates of the groups were not different (p>0.05). When compared, the durations of intensive care unit (ICU) stay were not statistically different (p>0.05), but mean duration of hospital stay (DHS) was longer in group A than group B (p less than 0.05).

CONCLUSION

Sigmoidectomy should be the basic principle in the management of sigmoid volvulus.RPA with modified blow - hole colostomy provides satisfactory results. It is easy to perform in patients with sigmoid volvulus. RPA with modified blow - hole colostomy can be performed safely in selected patients without increasing morbidity and DHS.

Hanhart syndrome

We report on a male infant with Hanhart Syndrome. It is classified in "oromandibular limb hypogenesis syndromes" which are a group of rare conditions involving congenital malformations of tongue, mandible, and limbs.

Giant well-differentiated liposarcoma of retroperitoneum

Liposarcoma is a malignancy of fat cells that occurs in deep soft tissue and mostly seen in limbs and retroperitoneum. It is the most common mesenchymal tumor of the retroperitoneum. It is detected at very late stages especially when the tumor gains substantial size, weight of several pounds at the time of diagnosis because it is grows very silently in deep tissues in the retroperitoneal area. Therefore, most of the patients with liposarcoma have no symptoms until the tumor is getting very large and pressurizes on neighboring structures which causes tenderness, pain, or functional disturbances. A 61 year-old male patient admitted with one-year history of abdominal pain, distention. Computed tomography demonstrated a large retroperitoneal mass in fat density filling the pelvic cavity extending to epigastric region especially in the left side of abdomen, and displacing intestines to the right and left kidney and pancreas gland posteriorly. At laparotomy the retroperitoneal tumor weighed 13.2 kg, Histologically it was a well-differentiated liposarcoma. Total extirpation surgery is still the most effective treatment in well-differentiated liposarcomas. Close follow-up after surgery is mandotary due to high rates of recurrence (Fig. 3, Ref. 10). Full Text (Free, PDF) www.bmj.sk.