Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-07-10DOI: 10.4274/balkanmedj.galenos.2024.2024-2-67
Chika Anna Idaguko, Gladys Agoreyo
{"title":"Effect of Wheat (<i>Triticum aestivum</i> Linn.) Diet on the Testes of Sprague-Dawley Rats","authors":"Chika Anna Idaguko, Gladys Agoreyo","doi":"10.4274/balkanmedj.galenos.2024.2024-2-67","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-2-67","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"404-406"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-08-16DOI: 10.4274/balkanmedj.galenos.2024.060824
Şiran Keske, Yasemin Özsürekci, Önder Ergönül
{"title":"An Alarming Emergence of Measles in Europe: Gaps and Future Directions","authors":"Şiran Keske, Yasemin Özsürekci, Önder Ergönül","doi":"10.4274/balkanmedj.galenos.2024.060824","DOIUrl":"10.4274/balkanmedj.galenos.2024.060824","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"321-323"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-08-29DOI: 10.4274/balkanmedj.galenos.2024.2024-5-99
Ahmet Furkan Kurt, Elif Seren Tanrıverdi, Metin Yalçın, Osman Faruk Bayramlar, Sibel Yıldız Kaya, Rıdvan Karaali, Mert Ahmet Kuşkucu, Fatma Köksal Çakırlar, Barış Otlu, İlker İnanç Balkan, Bilgül Mete, Gökhan Aygün, Fehmi Tabak, Neşe Saltoğlu
{"title":"Resistance Genes and Mortality in Carbapenem-resistant <i>Klebsiella pneumoniae</i> Bacteremias: Effects of the COVID-19 Pandemic","authors":"Ahmet Furkan Kurt, Elif Seren Tanrıverdi, Metin Yalçın, Osman Faruk Bayramlar, Sibel Yıldız Kaya, Rıdvan Karaali, Mert Ahmet Kuşkucu, Fatma Köksal Çakırlar, Barış Otlu, İlker İnanç Balkan, Bilgül Mete, Gökhan Aygün, Fehmi Tabak, Neşe Saltoğlu","doi":"10.4274/balkanmedj.galenos.2024.2024-5-99","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-5-99","url":null,"abstract":"<p><strong>Background: </strong>Emerging carbapenem-resistant <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>) (CRKP) bacteremias are presenting significant public health risks due to limited treatment options and increased mortality. <i>K. pneumoniae</i> isolates exhibit carbapenem resistance rates that vary from 25% to 50% throughout the European continent, including our country.</p><p><strong>Aims: </strong>To assess the characteristics of CRKP bacteremia, a condition that has recently demonstrated an increasing prevalence in our center. We sought to ascertain the resistance rates of isolated strains to antibiotics other than carbapenems, identify the responsible carbapenemase genes, evaluate the efficacy of antibiotics, determine mortality rates, explore clonality among strains, and investigate the influence of the COVID-19 pandemic on all these factors.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>This study included patients aged 18 and older who had experienced meropenem-resistant <i>K. pneumoniae</i> bacteremia. Meropenem resistance was confirmed by employing the Kirby-Bauer disk diffusion method. Meropenem minimum inhibitory concentration (MIC) levels were determined using the gradient test, while colistin MIC levels were ascertained using the disk elution technique. Carbapenemase genes were evaluated via colony polymerase chain reaction (PCR), and clonality analysis was performed using the arbitrarily primed PCR technique.</p><p><strong>Results: </strong>The study comprised 230 patients, with a mean age of 63.1 ± 15.9 years, of whom 58.7% were male. Oxacillinase-48 (OXA-48) was detected in 74.8% of the patients, New Delhi metallo-beta-lactamase (NDM) in 12.6%, OXA-48 + NDM in 7.8%, and KPC in 4.8%. The 14-day and 30-day mortality rates were 57% and 69.6%, respectively. Multivariate analysis of the 30-day mortality revealed several crucial factors, including bacteremia development in the intensive care unit, the occurrence of bacteremia during the COVID-19 pandemic, polymicrobial bacteremia, the use of indwelling intravenous catheters, a platelet count of ≤ 140,000/μl, procalcitonin levels of ≥ 6 μg/l, and a Charlson comorbidity score ≥ 3. Notably, the <i>OXA-48</i> and <i>KPC</i> genes were upregulated significantly during the COVID-19 pandemic, while the <i>NDM</i> gene groups were downregulated. Additionally, both 14-day and 30-day mortality rates increased significantly.</p><p><strong>Conclusion: </strong>In this study, the most prevalent carbapenemase gene was OXA-48; however, there has been a recent increase in <i>KPC</i> genes. No dominant epidemic strain was identified through clonality analysis. The clustering rate was 68% before the pandemic, increasing to 85.7% during the pandemic. The significance of infection control measures is underscored by the rise in both clustering and mortality rates during the COVID-19 pandemic.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"357-368"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-COVID Interstitial Lung Disease: How do We Deal with This New Entity?","authors":"Aycan Yüksel, Dilek Karadoğan, Nur Hürsoy, Tahsin Gökhan Telatar, Neslihan Köse Kabil, Feride Marım, İlknur Kaya, Aslıhan Banu Er, Merve Erçelik, Demet Polat Yuluğ, Merve Yumrukuz Şenel, Ceren İlgar, Ökkeş Gültekin, Selin Çakmakcı Karakaya, Bilge Yılmaz Kara, Neslihan Özçelik, İnci Selimoğlu, Kübra Uyar Er, Abdurrahman Kotan, Hasan Veysel Keskin, Metin Akgün","doi":"10.4274/balkanmedj.galenos.2024.2024-3-82","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-3-82","url":null,"abstract":"<p><strong>Background: </strong>In the postacute phase of coronavirus disease-2019 (COVID-19), survivors may have persistent symptoms, lung function abnormalities, and sequelae lesions on thoracic computed tomography (CT). This new entity has been defined as post-COVID interstitial lung disease (ILD) or residual disease.</p><p><strong>Aims: </strong>To evaluate the characteristics, risk factors and clinical significance of post-COVID ILD.</p><p><strong>Study design: </strong>Multicenter cross-sectional analysis of data from a randomized clinical study.</p><p><strong>Methods: </strong>In this study, patients with persistent respiratory symptoms 3 months after recovery from COVID-19 were evaluated by two pulmonologists and a radiologist. post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive defect on lung function tests, and interstitial changes on follow-up high-resolution computed tomography (HRCT).</p><p><strong>Results: </strong>At the three-month follow-up, 375 patients with post-COVID-19 syndrome were evaluated, and 262 patients were found to have post-COVID ILD. The most prevalent complaints were dyspnea (n = 238, 90.8%), exercise intolerance (n = 166, 63.4%), fatigue (n = 142, 54.2%), and cough (n = 136, 52%). The mean Medical Research Council dyspnea score was 2.1 ± 0.9, oxygen saturation was 92.2 ± 5.9%, and 6-minute walking distance was 360 ± 140 meters. The mean diffusing capacity of the lung for carbon monoxide was 58 ± 21, and the forced vital capacity was 70% ± 19%. Ground glass opacities and fibrotic bands were the most common findings on thoracic HRCT. Fibrosis-like lesions such as interlobular septal thickening and traction bronchiectasis were observed in 38.3% and 27.9% of the patients, respectively. No honeycomb cysts were observed. Active smoking [odds ratio (OR), 1.96; 95% confidence interval (CI), 1.44-2.67), intensive care unit admission during the acute phase (OR, 1.46; 95% CI, 1.1-1.95), need for high-flow nasal oxygen (OR, 1.55; 95% CI, 1.42-1.9) or non-invasive ventilation (OR, 1.31; 95% CI, 0.8-2.07), and elevated serum lactate dehydrogenase levels (OR, 1.23; 95% CI 1.18-1.28) were associated with the development of post-COVID ILD. At the 6-month follow-up, the respiratory symptoms and pulmonary functions had improved spontaneously without any specific treatment in 35 patients (13.4%). The radiological interstitial lesions had spontaneously regressed in 54 patients (20.6%).</p><p><strong>Conclusion: </strong>The co-existence of respiratory symptoms, radiological parenchymal lesions, and pulmonary functional abnormalities which suggest a restrictive ventilatory defect should be defined as post-COVID-19 ILD. However, the term “fibrosis” should be used carefully. Active smoking, severe COVID-19, and elevated lactate dehydrogenase level are the main risk factors of this condition. These post-COVID functional and radiological changes could disappear over time in 20% of the patients.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"377-386"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-08-12DOI: 10.4274/balkanmedj.galenos.2024.2024-4-119
Katarina Živančević, Başak Aru, Abdullah Demir, Lidija Radenović, Pavle Andjus, Gülderen Yanıkkaya Demirel
{"title":"Zn<sup>0</sup>-Induced Cytotoxicity and Mitochondrial Stress in Microglia: Implications of the Protective Role of Immunoglobulin G In Vitro","authors":"Katarina Živančević, Başak Aru, Abdullah Demir, Lidija Radenović, Pavle Andjus, Gülderen Yanıkkaya Demirel","doi":"10.4274/balkanmedj.galenos.2024.2024-4-119","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-4-119","url":null,"abstract":"<p><strong>Background: </strong>Zinc (Zn), an essential micronutrient, regulates and maintains neurological functions. However, both Zn deficiency and excess can cause oxidative stress and neurodegenerative diseases. As previously reported, immunoglobulin G (IgG) can modulate oxidative stress in various disorders.</p><p><strong>Aims: </strong>To investigate whether IgG treatment can alleviate oxidative stress caused by Zn<sup>0</sup> on microglia in vitro.</p><p><strong>Study design: </strong>In vitro study.</p><p><strong>Methods: </strong>The feasibility of Zn<sup>0</sup> treatment was evaluated using the MTS assay. Oxidative stress following treatment with Zn<sup>0</sup>, either alone or with IgG supplementation, was determined with dihydrorhodamine 123 staining. Flow cytometry was employed to ascertain the intracellular protein levels of TRIM21, PINK, PARKIN, MFN2, Beclin-1, and active LC3B.</p><p><strong>Methods: </strong>The feasibility of Zn<sup>0</sup> treatment was evaluated using the MTS assay. Oxidative stress following treatment with Zn<sup>0</sup>, either alone or with IgG supplementation, was determined with dihydrorhodamine 123 staining. Flow cytometry was employed to ascertain the intracellular protein levels of TRIM21, PINK, PARKIN, MFN2, Beclin-1, and active LC3B. Results: In silico screening confirmed the association between Zn<sup>0</sup> cytotoxicity and apoptosis. Furthermore, oxidative stress was identified as a critical mechanism that underlies Zn<sup>0</sup> neurotoxicity. The in silico analysis revealed that Zn can interact with the constant region of the Ig heavy chain, suggesting a potential role for IgG in alleviating Zn<sup>0</sup>-induced cytotoxicity. Experimental findings supported this hypothesis, as IgG administration significantly reduced Zn<sup>0</sup>-induced mitochondrial stress in a dose-dependent manner. The upregulation of PINK1 levels by Zn<sup>0</sup> exposure suggests that mitochondrial injury promotes mitophagy. Interestingly, Zn<sup>0</sup> decreased TRIM21 levels, which is reversed by IgG administration.</p><p><strong>Conclusion: </strong>These findings elucidate the cellular responses to Zn<sup>0</sup> and highlight the potential use of intravenous immunoglobulin in mitigating the adverse effects of acute Zn<sup>0</sup> exposure.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"348-356"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-07-10DOI: 10.4274/balkanmedj.galenos.2024.2024-3-87
Ayça Aydın, Ercan Yenilmez, Levent Görenek
{"title":"Two Cases of Cutaneous Larva Migrans and a Literature Review of the Condition","authors":"Ayça Aydın, Ercan Yenilmez, Levent Görenek","doi":"10.4274/balkanmedj.galenos.2024.2024-3-87","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-3-87","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"413-415"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-08-01DOI: 10.4274/balkanmedj.galenos.2024.190724
Mert İlker Hayıroğlu, Servet Altay
{"title":"Overlap Between Nutritional Indices in Patients with Acute Coronary Syndrome: A Focus on Albumin","authors":"Mert İlker Hayıroğlu, Servet Altay","doi":"10.4274/balkanmedj.galenos.2024.190724","DOIUrl":"10.4274/balkanmedj.galenos.2024.190724","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"324-325"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interferon Gamma in Sickness Predisposing to <i>Mycobacterial</i> Infectious Diseases","authors":"Betül Gemici Karaaslan, Jérémie Rosain, Jacinta Bustamante, Ayça Kıykım","doi":"10.4274/balkanmedj.galenos.2024.2024-8-18","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-8-18","url":null,"abstract":"<p><p>In recent decades, the prevalence of inborn errors of immunity has increased, necessitating the development of more effective treatment and care options for these highly morbid conditions. Due to these “experiments of nature,” the complicated nature of the immune system is being revealed. Based on the functional and molecular tests, targeted therapies are now being developed which offer a more effective approach and reduce damage. This study aimed to investigate a key cytokine of the cellular immune response, interferon‐gamma (IFN-γ), which is linked to Mendelian susceptibility to Mycobacterial disease, and its potential as a therapeutic option for IFN-γ deficiency.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"326-332"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balkan Medical JournalPub Date : 2024-09-06Epub Date: 2024-07-30DOI: 10.4274/balkanmedj.galenos.2024.2024-6-5
Wenchao Sun, Guier Chen
{"title":"An Infected Uterine Diverticulum due to a Cesarean Section","authors":"Wenchao Sun, Guier Chen","doi":"10.4274/balkanmedj.galenos.2024.2024-6-5","DOIUrl":"10.4274/balkanmedj.galenos.2024.2024-6-5","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"402-403"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}