Measles outbreak in the adult age group: Clinical, laboratory, and epidemiological features of the 11 patients admitted to the hospital

The measles virus, also known as the morbillivirus, or MV, is a virus that infects humans. The goal of this research is to assess to adult cases of measles. Eleven patients thought to be confirmed cases of measles were enrolled in the investigation. Following the identification of symptoms of tiredness, fever, and rash in one soldier, the results of 10 more troops from the pertinent military group were assessed. The diagnosis was made based on the presence of serum immunoglobulin M (IgM) and positive polymerase chain reaction (PCR) results. When the control IgM, immunoglobulin G, and PCR findings were evaluated a fortnight after hospitalization, a cluster of 11 incidents was found. It is now necessary to address the issue of the cautious stance towards vaccination or the anti-vaccination sentiment that has grown increasingly popular, particularly in light of the COVID-19 pandemic, for both our nation and the entire world.

C-PEPTIDE AS AN INFLAMMATORY MARKER IN OBESE WOMEN

Background

Insulin resistance (IR) is a component of type 2 diabetes and metabolic syndrome and it increases in the presence of chronic inflammation. Lately, "neutrophil-to-lymphocyte ratio" (NLR) has been used as an indicator of inflammation. This study evaluates the association between IR and NLR in obese women.

Material and methods

Obese female patients who were followed up in a university hospital for the last two years were included in the study. Homeostasis model assessment of IR (HOMA-IR), C-peptide, NLR, bioelectrical impedance measurements of 83 patients were analyzed.

Results

The C-peptide levels of our patients showed a highly significant correlation with HOMA-IR (p<0.001). A significant positive correlation was found between fasting plasma C-peptide levels and NLR (r=0.36 and p<0.003) in obese women. The increase in C-peptide levels had a significant effect on the increase in NLR (r2=0.31, p=0.002), however insulin had no similar effect on NLR (r2=0.01, p=0.544).

Conclusion

Plasma C-peptide levels are better correlated with NLR compared to other parameters of IR. C-peptide may be used as an efficient laboratory marker with high relevance in IR and chronic inflammatory conditions in obese women.

High serum AMH inhibits pathological growth of the low biomass endometrial microbiome

OBJECTIVE

Although host microbiome play a role in both hormonal status and fertility, this issue has not yet been clarified. Since the endometrium is a sterile tissue, it is accepted that microbiota does not grow under normal conditions. The aim of the study was to reveal the characteristics of endometrial microbiota according to serum AMH levels in women with implantation failure.

PATIENTS AND METHODS

Forty-five women aged 20-30 years with two or more implantation failures were included in the study. They were divided into 3 groups according to their serum AMH values: Group 1 -AMH <1.3 ng/ml; Group 2 - AMH between 1.3-2.6 ng/ml; Group 3 - AMH >2.6 ng/ml. Twenty-two healthy fertile women who were the same age as the infertile group and applied for cervical smear screening were accepted as the control group. Following the embryo transfer, the tip of the catheter was inserted into the transport medium under sterile conditions. Sowing was carried out by touching the tips of the catheter to the blood agar medium. After the evaluation of the petri dishes at the end of 48 hours of incubation, colonies were stained with Gram stain. Microorganisms in the colonies were identified with the Vitek-2 device according to their gram-staining characteristics and their antibiograms were made.

RESULTS

A negative correlation was detected between low AMH values and the microbiome detection rates in endometrial cultures. In patients with low serum AMH levels, the chance of endometrial microbiota growth was higher in the endometrial culture medium. The most common bacteria were found to be MSSA, MRKNS and lactobacillus. Clinical pregnancy rates were found to be significantly higher in the group with high AMH levels. As AMH levels increased, positive flora detection rates decreased, while clinical pregnancy rates increased.

CONCLUSIONS

Low serum AMH level increases the rate of positive endometrial microbiome in culture and decreases clinical pregnancy rates.

P-019 Semen analysis results are negatively affected in patients with vitiligo:a cross-sectional study

Study question

Does vitiligo affect the results of semen analysis?

Summary answer

Semen analysis results are negatively affected in patients with vitiligo.

What is known already

Vitiligo is a multifactorial disorder characterized by the loss of functional melanocytes, and both genetic and non-genetic factors play a pathogenic role.Male infertility is also a common problem, contributing to almost 50% of all infertility problems.It was reported that skin-derived cytokines triggered in diseases with inflammation in the skin negatively affect spermatogenesis and sperm viability.Although vitiligo is a common skin disorder, the pathogenesis remains unknown. It was shown that inflammation and oxidative stress was accepted as a trigger factor in melanocyte degeneration.It was emphasized that the increase in inflammation in the body might be indirectly related to male infertility.

Study design, size, duration

This cross-sectional study was conducted between January 2015 and January 2021 by retrospectively evaluating patients who underwent sperm analysis at an university hospital. All patients aged between 25-45 years who underwent semen analysis at the relevant dates were evaluated in terms of the study (N = 5167).76 patients with vitiligo and 71 healthy controls were included in our study. The diagnosis of vitiligo was made clinically and using Wood's lamp.

Participants/materials, setting, methods

The control group was selected from among age and BMI-matched patients who underwent semen analysis (n = 71).The parameters examined in the study were as follows: Characteristics of cases (age, BMI, family history), Disease features (duration of disease, clinical type, Koebner phenomenon, halo naevi)The level of hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroxine (FT4), thyroid-stimulating hormone (TSH), testosterone, prolactin], and blood glucose, Semen analysis (volume, sperm concentration, total motility, A + B motility, morphology).

Main results and the role of chance

Seventy-six patients with vitiligo and 71 healthy controls were included in our study. The mean age was 30.29 ± 4.18 (range, 25-45) years. The mean age at onset was 23.66 ± 3.96 (range, 15-35) years, and the mean duration of disease was 6.36 ± 2.80 (range, 2-20) years in the vitiligo group. Sixty-seven (88.16%) patients had non-segmental vitiligo and nine (11.84%) had segmental vitiligo. Seven (9.21%) patients had a family history, three (3.95%) had Koebner phenomenon, and one (1.32%) patient had halo naevi.Free T4 levels were significantly lower in the vitiligo group than in the control group (P &lt; 0.001) There were no significant differences between the groups regarding age, BMI, FSH, LH, TSH, testosterone, prolactin, and blood glucose levels. When we evaluated the semen analysis results, we found that sperm concentrations A+B motility and morphology were significantly higher in the controls than in the patients with vitiligo (P &lt; 0.001,p&lt;0.01,and P &lt; 0.001) )There were no significant differences between the groups concerning volume and total motility. We divided patients with vitiligo into three groups according to their sperm concentrations.There were no significant differences between groups regarding age and BMI Free T4 levels were significantly higher in the control group than in the other groups. (p &lt; 0.001).

Limitations, reasons for caution

The retrospective design of the study is an important limitation. Although the relationship between vitiligo and sperm parameters has been examined, the direction and cause of this relationship could not be determined due to the study design.

Wider implications of the findings

Inflammation and oxidative stress may affect sperm quality.One of the reasons for the more negative results in sperm analysis parameters in patients with vitiligo in our study might be due to increased inflammation level.Oxidative stress may be the trigger factor in the destruction of melanocytes as well as semen parameters.

Trial registration number

not applicable

Salivary β-galactosidase, halitosis parameters in periodontal health and disease, and their changes after periodontal treatment

BACKGROUND

In this study, we aimed to evaluate the salivary β-galactosidase and Halimeter values (HMV), organoleptic scores (OLS) and Winkel tongue coating index (WTCI) in periodontal health and periodontitis (P), and also their changes after phase I periodontal therapy and tongue cleaning.

METHODS

The participants were separated as follows: 25 P with halitosis (Group 1), 25 P without halitosis (Group 2) and 25 healthy controls (Group 3). Periodontal recordings, HMV, OLS and WTCI scores were recorded, and whole saliva β-galactosidase levels were measured colorimetrically in the samples at baseline and 1 month after the therapy.

RESULTS

The baseline values of HMV, OLS, WTCI and salivary β-galactosidase levels were significantly higher in Group 1 than in Group 2 (P < 0.05). There was a statistically significant decrease in periodontal recordings, HMV, OLS, WTCI and salivary β-galactosidase levels in all P patients by the therapy (P < 0.05). However, major reductions in halitosis measurements and saliva enzyme levels were observed in Group 1 after the treatment.

CONCLUSION

Our results showed that salivary β-galactosidase was associated with halitosis parameters and phase I periodontal therapy played an important role to reduce this enzyme level and halitosis parameters in P.

Association between TSH Values and GFR Levels in Euthyroid Cases with Metabolic Syndrome

BACKGROUND

Metabolic syndrome (MetS) is associated with the risk of developing chronic kidney disease. Although the negative effects of high thyroid-stimulating hormone (TSH) values on glomerular filtration rate (GFR) levels have been known for years, the negative effects of increased TSH on GFR in euthyroid cases have been reported in recent years. This study was aimed at investigating the association between the effect of increased TSH values and estimated-GFR (eGFR) levels in euthyroid cases with MetS.

METHODS

For this hospital-based descriptive study, 191 MetS cases (123 females, 68 males) were evaluated. Those whose TSH was not within 0.5-4.5 uIU/mL, eGFR was <40 mL/min/1.73 m², and/or reported any thyroid/kidney disease were excluded. Partial correlation coefficients were calculated to investigate the relationship between the eGFR values and several other numerical variables while controlling for age and BMI in addition to the adjusted gender effect. Thereafter, the multiple linear regression analysis with a stepwise variable selection approach was used to reveal the independent factors that could affect the logarithmically transformed eGFR.

RESULTS

The median age was 52 (19-65) years, the median eGFR was 94.3 (41.3-194) mL/min/1.73 m², and the median TSH was 1.58 (0.50-4.50) uIU/mL in the whole group. Increased TSH even in the normal range was associated with eGFR after adjusting for age and body mass index (BMI), especially in females. The high age (b = -0.160, p=0.005), high BMI (b = -0.134, p=0.020), high TSH (b = -0.380, p < 0.01), and high uric acid (b = -0.348, p < 0.01) were found as significant predictors of the eGFR in MetS patients.

CONCLUSION

Independent of age and BMI, elevated TSH even in the euthyroid range showed an association with the eGFR in female MetS cases who had normal kidney functions. This correlation was stronger than the correlations between the eGFR and the MetS diagnostic parameters. These findings need further studies on the issue..

Relapsing Serratia peritonitis resulting in peritoneal catheter loss

Serratia marcescens (SM) is an opportunistic Gram-negative bacterium. It can cause technique failure or severe sepsis despite being a rare agent causing peritonitis. We present a case of a 40-year-old woman with end-stage renal disease secondary to chronic glomerulo-nephritis on continuous ambulatory peritoneal dialysis (PD). She presented with severe abdominal pain and a cloudy peritoneal fluid. The fluid was cultured according to our unit protocol. The organism isolated was identified as SM; this was after the patient was treated for SM peritonitis one week earlier. The response to treatment with ceftazidime was poor despite being sensitive in vitro. The peritoneal catheter was removed due to rapid clinical deterioration. Piperacillin-tazobactam (PIP/TAZ) monotherapy was successfully administered subsequently. Eventually, she was transferred to hemodialysis (HD). SM is an uncommon cause of PD-related peritonitis. It may cause catheter loss and even death. In our case, the infection could be controlled only after catheter removal, and she was transferred to HD. Cephalosporins should rapidly be changed to PIP/TAZ when SM is isolated from the peritoneal fluid.

Flexible and fragmentable tandem photosensitive nanocrystal skins

We proposed and demonstrated the first account of large-area, semi-transparent, tandem photosensitive nanocrystal skins (PNSs) constructed on flexible substrates operating on the principle of photogenerated potential buildup, which avoid the need for applying an external bias and circumvent the current-matching limitation between junctions. We successfully fabricated and operated the tandem PNSs composed of single monolayers of colloidal water-soluble CdTe and CdHgTe nanocrystals (NCs) in adjacent junctions on a Kapton polymer tape. Owing to the usage of a single NC layer in each junction, noise generation was significantly reduced while keeping the resulting PNS films considerably transparent. In each junction, photogenerated excitons are dissociated at the interface of the semi-transparent Al electrode and the NC layer, with holes migrating to the contact electrode and electrons trapped in the NCs. As a result, the tandem PNSs lead to an open-circuit photovoltage buildup equal to the sum of those of the two single junctions, exhibiting a total voltage buildup of 128.4 mV at an excitation intensity of 75.8 μW cm(-2) at 350 nm. Furthermore, we showed that these flexible PNSs could be bent over 3.5 mm radius of curvature and cut out in arbitrary shapes without damaging the operation of individual parts and without introducing any significant loss in the total sensitivity. These findings indicate that the NC skins are promising as building blocks to make low-cost, flexible, large-area UV/visible sensing platforms with highly efficient full-spectrum conversion.

Dual ectopic thyroid gland with Graves' disease and unilateral ophthalmopathy: a case report and review of the literature

Ectopic thyroid gland (ETG) is a rare entity and can be seen anywhere in the route of descending gland. It is much rarer when encountered away from the midline. Dual ETG is such a rare entity that only a few have been reported in the literature. ETGs not only cause thyroid dysfunction, most commonly hypothyroidism and rarely hyperthyroidism, but also frequent local symptoms. Therapeutic options change according to patients' co-morbid diseases, age, size of goiter and presence of local symptoms. Graves' disease is very rarely detected in a patient with ectopic thyroid. There is no report in literature concerning ectopic thyroid presenting with Graves' disease and unilateral ophthalmopathy. We describe a case with dual ETG and Graves' disease and unilateral ophthalmopathy: it is the first reported in literature.

Epidemiological, clinical and laboratory features of brucellosis: a prospective evaluation of 120 adult patients

This prospective study was carried out in the department of infectious diseases of Gaziantep University between January 1997 and December 1999 to evaluate the epidemiological, clinical and laboratory features of brucellosis in south-eastern Turkey. One hundred and twenty consecutive patients with active brucellosis were enrolled. The commonest way of transmission was ingestion of milk products from diseased animals. Brucella melitensis was isolated in the specimens of 31 (45.5%) of 68 patients. The commonest abnormalities on physical examination were fever (66.6%), hepatomegaly (63.3%) and splenomegaly (56.6%). Osteoarticular involvement was found in 34 patients (28.3%). Fifteen (12.5%) patients had ocular involvement. Hepatitis, orchiepididymitis, pulmonary involvement and meningitis were found in one (0.8%), four (6.8%), three (2.5%) and one (0.8) patient, respectively. The commonest haematological abnormalities were relative lymphomonocytosis (71.6%) and anaemia (36.6%). In conclusion, brucellosis continues to be a common health problem in communities where the consumption of unpasteurised dairy products is common. Since prevention is as important as early diagnosis in reducing the morbidity of brucellosis, we suggest that improving current health policies with additional educational programmes is essential.