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Purpose: The effects of different COVID-19 therapeutic strategies on cardiac function are uncertain. Therefore, this study aimed to evaluate the effects of different medical treatments on biventricular function in patients who had recovered from COVID-19. Materials and Methods: Speckle-tracking echocardiography was performed to examine the biventricular myocardial function of patients at follow-up visits after recovery from COVID-19. The patients were divided into two groups based on the medication they used during the active disease: favipiravir (FAV; n = 60) or hydroxychloroquine (HCQ; n = 60). A comparison was made with risk factor–matched controls (n = 41). Results: A total of 161 patients were included in the study. The left ventricular end-diastolic volume, end-systolic volume, end-diastolic diameter, and end-systolic diameter were higher in the HCQ and FAV groups compared to the controls, while the left ventricular ejection fraction was similar between all the groups. The right ventricular diameter was increased, and the systolic pulmonary artery pressure was higher in the HCQ and FAV groups compared to the controls. The left ventricular global longitudinal strain (-18±6.6 vs. -19.7±4.4 vs. -20.4±5, respectively), the right ventricular global longitudinal strain (-19.8±7.5 vs. -22.2±6 vs. -23.4±6.2, respectively), and the right ventricular free wall strain (-16.9±3.6 vs. -18.2±2.4 vs. -19.6±4.7, respectively) were worse in the HCQ group compared to the FAV and control groups. Conclusion: This study found echocardiographic evidence of subclinical cardiac involvement in both the HCQ and FAV groups compared to the controls. However, HCQ treatment was associated with an increased risk of biventricular subclinical systolic dysfunction in COVID-19 survivors compared with FAV treatment.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 virus was found to have effects not only in the lungs but also in many different organs. We aimed to evaluate the management of our patients with inflammatory bowel disease in this pandemic, the incidence of coronavirus disease 2019 in terms of clinical, medical treatment, and features of inflammatory bowel disease, and to investigate the effects of the severe acute respiratory syndrome coronavirus 2 on this particular group of patients. METHODS: During the coronavirus disease 2019 pandemic, 207 patients who had inflammatory bowel disease for at least 6 months were questioned for coronavirus disease 2019 at their outpatient clinic admissions, and their medical records were evaluated prospectively. RESULTS: Of the 207 patients, 146 had Crohn’s disease. The mean disease duration was determined as 118.15 ± 72.85 months. Of the patients, 127 (61.4%) were using mesalazine, 110 (53.1%) azathioprine, and 148 (71.5%) biological agents. It was found that 66 (31.9%) patients changed their medications during the coronavirus disease 2019 pandemic. As a medication change, anti-Tumor Necrosis Factor (TNF) dose was observed to be omitted most frequently at a rate of 80%. Diarrhea was present in 20.8%, abdominal pain in 20.3%, nausea in 10.6%, anorexia in 13.5%, and weight loss in 15.9% of the patients. Twelve (5.79%) patients were diagnosed with coronavirus disease 2019. Lung involvement was present in 11 (91.7%) of the patients diagnosed with coronavirus disease 2019. Of the patients diagnosed and not diagnosed with coronavirus disease 2019, 75% vs. 71.6% were using biological agents (P = .80), respectively. Half of the patients diagnosed with coronavirus disease 2019 were active in terms of inflammatory bowel disease at the time of diagnosis, and 2 of these patients were severely active. CONCLUSION: The incidence of coronavirus disease 2019 infection in patients with inflammatory bowel disease was not different from the general population during the severe acute respiratory syndrome coronavirus 2 pandemic. Coronavirus disease 2019 infection does not progress with poor prognosis in patients with inflammatory bowel disease who receive immunosuppressive therapy including biological agents.

Aim:We investigated the level of knowledge about influenza, pneumococcal, herpes zoster and tetanus vaccines recommended by the World Health Organization (WHO) for individuals aged 65 and over.Methods:A total of 147 patients aged 65 and over who attended to the Internal Diseases Outpatient Clinic in İstanbul University Faculty of Medicine Hospital were included in this study. A 21-item questionnaire was administered to the participants.Results:Fifty-three point seven percent of the elderly who participated in the study had been vaccinated. Influenza vaccine was the most known (56.5%), and tetanus vaccine was the most commonly used (32.7%) vaccine. When the 65-74 age group was taken as a reference, the percentage of adults aged 75 years and older who were not vaccinated was 2.56 times higher [confidence interval (CI): 1.20-5.44; p=0.014]; when those who received information about the vaccines were taken as a reference, in those who did not receive information, the percentage of adults who were not vaccinated was 2.48 times higher (CI: 1.19-5.18; p=0.016); when patients with chronic diseases were taken as reference, in patients without any chronic disease, the percentage of individuals who were not vaccinated was 6.30 times higher (CI: 1.60-24.85; p=0.009).Conclusion:It is important for the elderly population to have vaccines recommended by WHO, healthcare professionals to inform people about vaccines and to recommend these vaccines. New regulations should be made for the immunization of people aged 75 and over. In this context, family physicians may be recommended to follow the immunization status of this age group specifically or to provide immunization services to these people within the framework of home health services.

Local anesthetics are used to anesthetize surface areas in several procedures. The history of anesthesia exposure has been established as an important factor for correct diagnosis. When they are used excessively, some systemic side effects such as methemoglobinemia, respiratory failure, cardiovascular arrhythmias, or neurological manifestations may occur. Methemoglobinemia which usually presents with nonspecific symptoms is a serious entity. It is a rare but severe side effect of anesthetics. We herein present a case of methemoglobinemia due to local anesthesia with prilocaine.

Objective: In this study, we aimed to analyze the demographic characteristics, symptoms, and comorbidities of 504 patients hospitalized for COVID-19. We also sought to describe the relationship between these features and intensive care unit (ICU) admission and mortality. Material and Methods: This study is a descriptive study involving 504 COVID-19 patients hospitalized between 16.03.2020 and 07.05.2020 at Istanbul University’s Faculty of Medicine Hospital. Information about the patients was obtained from the hospital automation system and evaluated retrospectively. Results: The average age of the 504 patients was 56±15.14, and 59.1% of them were male. The proportion of the patients admitted into ICU 11.9% and for 8.52% of them the disease resulted in death. Real time polymerase chain reaction (RT-PCR) test results were positive for 60.5% of the patients. The median time spent in the hospital was eight days. Fifty six percent of the patients had at least one accompanying comorbid disease, with hypertension (39.3%) and diabetes (20.8%) being the most common. Being 65 years old or older (p

Amac: Sistemik inflamasyon gostergesi olan notrofil-lenfosit orani (NLR), kanser hastalarinda son zamanlarda onerilen basit ve ucuz bir prognostik faktordur. Calismamizda, tedavi oncesi yuksek NLR degerinin lenfoma hastalarinda kotu sagkalimi gosterdigi hipotezine dayanarak lenfoma hastalarinda tedavi oncesi NLR degerlerinin geriye donuk prognostik anlamini inceledik. Gerec ve Yontem: Calismamiza Ocak 2011 ve Aralik 2017 tarihleri arasinda Istanbul Tip Fakultesi ic hastaliklari ve geriatri bolumunde tani konulan, takip ve tedavi edilmis 18 yas ustu lenfoma tanili hastalar dahil edildi. Sekseniki hastanin verileri retrospektif olarak hastane otomasyon sistemlerinden elde edildi. NLR ve temel karakteristikleri laboratuar parametreleri, prognoz ve sagkalim sonuclari arasindaki iliski degerlendirildi. Bulgular: HL hastalarinda, tani aninda daha ileri yas grubundaki hastalarda yuksek mortalite hizi ve plevral efuzyonun varligi uzun donem sagkalim uzerine anlamli negatif etkiye sahipti (p=0,008, p=0,035). NHL hastalarinda, ileri yas yuksek IPI skoru, dusuk PLT seviyesi ve yuksek beta 2 mikroglobulin duzeyi yuksek mortalite oraniyla iliskili bulundu (p=0,001, p=0,044, p=0,023, p=0,009). Sonuc: HL ve NHL hastalarinda NLR ile mortalite ve uzun donem sagkalim arasinda bir iliski gosterilememistir. Bu retrospektif analizin kucuk bir orneklem buyuklugune sahip olmasi, gec tani konulmus hasta populasyonu ve tek merkezli bir calisma olmasi bu beklenmedik sonucun nedeni olabilir.

Objective: Older adults have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (Results: The median age was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male. There were 104 (28.7%) patients ≥65 years of age. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue/myalgia (89.4%), dry cough (72.1%), and fever (63.5%). Cough and fever were significantly less prevalent in older adults compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia was present in 31.5% of the study population being more common in older adults (49% vs. 24.4%) (pConclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

Objective: The aim of this study is to investigate the role of sTREM-1 molecule in the diagnosis of spontaneous bacterial peritonitis in patients with portal type ascites. Material and Method: We included 122 patients with portal type ascites in the study, 58 had infected ascites (peritonitis) (F/M:27/31, mean age 61.6±15.0 years) and 64 had uninfected ascites (F/M:23/41, mean age 63.4±9.4). Complete blood count, albumin, and C-reactive protein (CRP) were defined in the blood samples. Additionally, neutrophil count, albumin, total protein, lactate dehydrogenase (LDH), and sTREM-1 levels were measured in the peritoneal fluid samples. Results: There were significant differences in ascites neutrophil, serum neutrophil, CRP, ascites LDH, and ascites sTREM-1 levels between two groups. AUC values for ascites neutrophil, serum neutrophil, CRP, and sTREM-1 were 1.0 (95% CI 1.0-1.0), 0.676 (95% CI 0.580-0.771), 0.721 (95% CI 0.632-0.811), and 0.644 (95% CI 0.546-0.74), respectively. In females, sTREM-1 levels were positively correlated with ascites neutrophil, ascites LDH, ascites albumin, ascites total protein levels, and platelet count. Conclusion: Infection of ascites is an important complication of portal hypertension and ascites neutrophil count measurement is the traditional method used for diagnosis. sTREM-1 can be an alternative marker to identify ascites infections, especially in the cases of peritonitis without an increase in neutrophil count., Amaç: Bu çalışmanın amacı portal tipte asidi olan hastalarda sTREM-1 molekülünün spontan bakteriyel peritonit tanısındaki rolünü araştırmaktır. Gereç ve Yöntem: Çalışmaya portal tipte asiti olan 122 hasta dahil edildi, 58 hastada enfekte asit (K/E:27/31, ortalama yaş 61,6±15,0 yıl), 64 hastada enfekte olmayan asit (K/A:23/41, ortalama yaş 63,4±9,4) vardı. Hastalardan başvuru sırasında alınan kan örneklerinde tam kan sayımı, albümin ve C-reaktif protein (CRP) değerleri; eşzamanlı alınan periton sıvısı örneklerinde ise albümin, total protein, laktat dehidrojenaz, (LDH) ve sTREM-1 seviyeleri ölçüldü. Bulgular: Enfekte asitli ve enfekte olmayan asitli hastalar karşılaştırıldığında asit nötrofil, serum nötrofil, CRP, asit LDH ve asit sTREM-1 düzeylerinde anlamlı farklılıklar görüldü. Asit nötrofil, serum nötrofil, CRP ve sTREM-1 için eğrinin altında kalan alanlar (EAA) sırasıyla 1,0 (%95 CI 1,0-1,0), 0,676 (%95 CI 0,580-0,771), 0,721 (%95 CI 0,632-0,811) ve 0,644 (%95 CI 0,546-0,74) idi. Ayrıca kadın hastalarda sTREM-1 değerleri; asit nötrofil, asit LDH, asit albümin, asit total protein değerleri ve trombosit sayısı ile pozitif korelasyon gösterdi. Sonuç: Asit enfeksiyonu portal hipertansiyonun önemli bir komplikasyonudur ve geleneksel tanı metodu asit nötrofil sayısı ölçümüdür. sTREM-1, özellikle nötrofil sayısında artış olmayan peritonit vakalarında, asit enfeksiyonlarını tanımlamak için alternatif bir belirteç olabilir.