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Aim: Evaluate the impact of Tenofovir Disoproxil Fumarate (TDF) treatment on bone mineral density (BMD) for patients with chronic hepatitis B (CHB) with Dual X-ray absorptiometry (DEXA) and the Fracture Risk Assessment Tool (FRAX) score. Materials and Methods: A total of 38 CHB patients treated with TDF were included in this retrospective study. To estimate BMD, DEXA, demographic details, and laboratory values were examined in patients. The BMD measurements were compared after dividing the patients into 3 groups as normal BMD, osteopenic, and osteoporotic. FRAX scores (before and after DEXA) were calculated. Results: Twenty-one of the 38 (55.3%) cases of CHB infection were male, the median age was 51 (min-max: 29-71) years, and seven patients (18.4%) were over 60 years of age. The median TDF duration was median 6 (min-max: 3-13) years. Osteopenia, defined by DEXA results, was found in 17 patients (44.7%) at the lumbar spine site, 11 (28.9%) at the femoral neck, and 10 (26.3%) at the total hip. Osteoporosis was detected in six patients (15.8%) at the lumbar spine site. Pre-DEXA FRAX score and post-DEXA FRAX score were calculated. Only one patient (1/33, 3%) had a score over the intervention threshold, by post-DEXA FRAX score. None of the patients classified as low risk based on the pre-DEXA FRAX score had a post-DEXA FRAX score above the intervention threshold. When the TDF duration, serum phosphorus level, vitamin D levels, and ALP levels were compared, no significant differences were found between the groups. Conclusion: There are concerns about the negative effects of TDF used in CHB infection on BMD. However, BMD loss may not increase as the duration of TDF use increases. FRAX score is useful in identifying to risk of osteoporotic fracture. FRAX score can also eliminate the need for DEXA in most CHB cases. The FRAX score should be used in clinical practice to determine cases at risk. [ABSTRACT FROM AUTHOR]

Background: The development of candidemia is a highly fatal condition in severe COVID‐19 infection. Objectives: This study aimed to develop a candidemia prediction score in COVID‐19 patient based on the patient's clinical characteristics, and healthcare‐related factors during intensive care units (ICU) follow‐up. Patients/Methods: Severe COVID‐19 patients hospitalised in ICU in Ankara City Hospital during the one‐year period (August 15, 2020, and August 15, 2021) were included. After univariate analysis, multivariate analysis was applied using variable selection approach to investigate the effects of variables together and to create a score model for candidemia. Statistically significant factors were included in the development process of candida prediction score. Results: Of 1305 COVID‐19 ICU patients, 139 had a candidemia episode. According to the final model, four variables, presence of central venous catheter (CVC) (OR 19.07, CI 8.12–44.8, p <.0001), multifocal colonisation (OR 2.28, CI 1.39–3.72, p 0.001), length of ICU stays ≥14 days (OR 3.62, CI 2.42–5.44, p <.0001) and corticosteroids (OR 0.51, CI 0.34–0.76, p 0.0011) were the only statistically significant independent risk factors for candidemia. Score model was demonstrated by a nomogram, and the risk for candidemia was calculated to be high in patients who scored ≥56 points by using the criteria [CVC = 51, multifocal colonisation = 14, prolonged hospitalisation = 23, no steroid use = 12 points]. The AUC of the score is 0.84 (CI 0.81–0.87). Conclusion: We developed and validated an easy‐to‐use clinical prediction score for candidemia in severe COVID‐19 infection. In COVID‐19 ICU patients, the risk of candidemia is high if one of the other risk factors is present together with CVC. [ABSTRACT FROM AUTHOR]

We present the interim results of the efficacy, immunogenicity, and safety of the two-dose schedules of TURKOVAC versus CoronaVac. This was a randomized, observer-blinded, non-inferiority trial (NCT04942405). Volunteers were 18–55 years old and randomized at a 1:1 ratio to receive either TURKOVAC or CoronaVac at Day 0 and Day 28, both of which are 3 μg/0.5 mL of inactivated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) adsorbed to aluminum hydroxide. The primary efficacy outcome was the prevention of polymerase chain reaction (PCR)-confirmed symptomatic coronavirus disease 2019 (COVID-19) at least 14 days after the second dose in the modified per-protocol (mPP) group. Safety analyses were performed in the modified intention-to-treat (mITT) group. Between 22 June 2021 and 7 January 2022, 1290 participants were randomized. The mITT group consisted of 915 participants, and the mPP group consisted of 732 participants. During a median follow-up of 90 (IQR 86–90) days, the relative risk reduction with TURKOVAC compared to CoronaVac was 41.03% (95% CI 12.95–60.06) for preventing PCR-confirmed symptomatic COVID-19. The incidences of adverse events (AEs) overall were 58.8% in TURKOVAC and 49.7% in CoronaVac arms (p = 0.006), with no fatalities or grade four AEs. TURKOVAC was non-inferior to CoronaVac in terms of efficacy and demonstrated a good safety and tolerability profile. [ABSTRACT FROM AUTHOR]

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Background: Critically ill COVID‐19 patients have a high risk for the development of candidemia due to being exposed to both well‐defined classical risk factors and COVID‐19‐specific risk factors in ICU. Objectives: In this study, we investigated the incidence of candidemia in critically COVID‐19 patients, and the independent risk factors for candidemia. Patients/methods: COVID‐19 patients hospitalised in ICU during 1‐year period (August 2020 to August 2021) were included. Clinical and laboratory characteristics of all COVID‐19 patients, applied treatments, and invasive procedures that may predispose to candidemia were recorded. Results: Of 1229 COVID‐19 patients, 63 developed candidemia. Candidemia incidence rate was 4.4 episodes per 1000 ICU days. The most common species was Candida albicans (52.3%). Only 37 patients (58.7%) received antifungal therapy. The presence of central venous catheter (OR 4.7, 95% CI 1.8–12.2, p <.005), multifocal candida colonisation (OR 2.7, 95% CI 1.4–5.2, p <.005), a prolonged ICU stay (≥14 days) (OR 1.9, 95% CI 1.08–3–37, p <.05), the absence of chronic lung disease (OR 0.4, 95% CI 0.1–0.9, p <.05) and the absence of corticosteroid use (OR 0.3, 95% CI 0.14–0.52, p <.0001) were significantly associated with candidemia. Conclusions: Our study filled the knowledge gap in the literature about the impact of COVID‐19‐associated risk factors for the development of candidemia. The classical risk factors for candidemia had a significant effect on candidemia, and contrary to expectations, corticosteroids had a protective effect against the development of candidemia. The results of these studies showing interesting effects of corticosteroids in critically ill COVID‐19 patients should be confirmed by further studies. [ABSTRACT FROM AUTHOR]

Objectives: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome. Coronavirus 2 (SARS-CoV-2) is spreading rapidly around the world. Asymptomatic infection is highly contagious, potentially leading to viral spread. We aimed to determine the rate of patients positive for COVID19 PCR performed for safety measures before thyroid fine-needle aspiration biopsy (FNAB). Materials and Methods: The patients applied to Ankara City Hospital, Endocrinology and Metabolism Clinics between 15.03.2020 and 15.08.2020 and underwent routine COVID-19 PCR test before FNAB were evaluated retrospectively. Age, gender, history of hypertension and Type 2 Diabetes Mellitus (T2DM), use of levothyroxine (LT4) or antithyroid drug, 25-hydroxyvitamin D3 [25(OH)D3], TSH, freeT3 (fT3), free (fT4) levels, FNAB results were obtained from the records. Results: Asymptomatic COVID-19 infection was detected in 29 (2.43%) of 1195 patients who underwent FNAB. There was no statistically significant difference between patients with COVID-19 PCR test positive asymptomatic and negative patients in terms of age, gender, median values of 25(OH)D3, TSH, fT3, fT4, the ratio of hypertension and T2DM. Conclusion: The healthcare professionals work devotedly against COVID-19 infection, demonstrating a great example of struggle worldwide. FNAB is an invasive procedure requiring close contact. It should be known by the clinician that COVID-19 infection is associated with a high risk of transmission in asymptomatic patients. The rate of 2.43% in the population cannot be underestimated and indicates the importance of the use of personal protective equipment and taking infection prevention measures. [ABSTRACT FROM AUTHOR]

Post recovery manifestations have become another concern in patients who have recovered from coronavirus disease 2019 (COVID‐19). Numerous reports have shown that COVID‐19 has a variety of long‐term effects on almost all systems including respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems. We aimed to investigate the prevalence and characteristics of the post‐COVID syndrome among COVID‐19 survivors and to determine the factors associated with persistent symptoms. This prospective study enrolled in patients with COVID‐19 followed in hospital or outpatient clinics in Ankara City Hospital. We performed a special questionnaire to inquire about the presence of persistent symptoms beyond 12 weeks from the first diagnosis. Demographic data, comorbid diseases, characteristics of acute COVID‐19, presence of persistent symptoms by systems, and knowledge about outpatient clinic visits after recovery were assessed. Of a total of 1007 participants, 39.0% had at least one comorbidity, and 47.5% had persistent symptoms. Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%) followed by respiratory symptoms (25.4%). A total of 235 participants had visited outpatient clinics due to several reasons during the post‐COVID‐19 period, and 17 of them were hospitalized. Severe acute COVID‐19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms. Fully understanding the spectrum of the post‐COVID syndrome is essential for appropriate management of all its long‐term effects. Our study once again underlined the fact that the prevalence of post‐COVID syndrome is higher than expected and concerns many systems, and a multidisciplinary follow‐up should be provided to COVID‐19 survivors in the post recovery period. Highlights: COVID‐19 has a variety of long‐term effects on almost all systems.Respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems are affected in different degree.We detected the prevalence of the post?COVID syndrome among COVID‐19 survivors as 47.5% on 1007 participant.Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%), and followed by respiratory symptoms (25.4%).Severe acute COVID‐19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms. [ABSTRACT FROM AUTHOR]

Background: Various variants of the COVID‐19 have started to attract attention recently. The clinical course of these variants and possible predictive parameters are being investigated. This study aimed to examine the relationship between thiol levels, which are indicators of oxidative stress, and variant COVID‐19 types. Methods: In this cross‐sectional study, patients with a diagnosis of classic COVID‐19 and patients with a diagnosis of variant COVID‐19 with mild and moderate symptoms followed in the clinical observatory of Ankara city hospital were included in the study group. The patients were divided into two groups according to the COVID‐19 type as a variant and classic COVID‐19, and a healthy control group was added for comparison. A complete blood count and thiol analysis were performed from the venous blood samples. Obtained results were compared between groups, and the ROC analysis was performed. Results: Thiol levels were significantly lower in patients with a diagnosis of COVID‐19 compared with the control group. In terms of WBC, lymphocyte, neutrophil, NLR, ferritin and thiol parameters, patients with variant COVID‐19 differed significantly from patients with a classic COVID‐19 diagnosis. Thiol levels' cut‐off values to distinguish between variant COVID‐19 patients and control group from classical COVID‐19 patients were almost identical (423 and 422 µmol/L, respectively). Conclusions: It seems possible to use thiol as a sensitive, specific and cost‐effective marker to suspect variant COVID‐19 cases. Since this study is probably the first example in this subject, it would form a basis for further studies. [ABSTRACT FROM AUTHOR]

Severe COVID‐19 patients in ICU are at high risk for candidemia due to exposure to multiple risk factors for candidemia. We aimed to compare the incidence of candidemia in ICU patients with and without COVID‐19, and to investigate epidemiologic and clinical characteristics of candidemia patients and risk factors for mortality in candidemia patients. This retrospective study was conducted in patients followed in the ICUs of Ankara City Hospital for 2 years, divided into pre‐pandemic and pandemic periods. The incidence (event per 1000 patient‐days) and epidemiology of candidemia, clinical and laboratory characteristics of patients were compared in COVID‐19 and non‐COVID‐19 groups. Candidemia incidence was higher in the COVID‐19 group (2.16, 95% CI 1.77–2.60) than the non‐COVID‐19 group (1.06, 95% CI 0.89–0.125) (p <.001). A total of 236 candidemia episodes (105 in COVID‐19 patients and 131 in non‐COVID‐19 patients) were detected during the study periods. COVID‐19 cases had a higher rate of corticosteroid use (63.8% vs. 9.9%, p <.001). Epidemiology of candidemia and antifungal susceptibility were similar. Candidemia developed 2 weeks earlier in COVID‐19 groups and resulted in higher mortality (92.5% vs. 79.4%, p.005). One‐third of candidemia patients died before receiving any antifungal treatment, and this rate was higher in the COVID‐19 group. In multivariate logistic regression analysis, corticosteroid use, presence of sepsis and age older than 65 years were independent risk factors for mortality in candidemia patients. Candidemia with high mortality is a more serious problem for COVID‐19 patients due to its increased incidence, earlier occurrence and a higher rate of mortality. [ABSTRACT FROM AUTHOR]

COVID‐19 pandemic has been affecting the whole world by increasing morbidity and mortality rates day by day. Treatment algorithms have been attempted as parallel to the increasing experience with COVID‐19. In the pathogenesis of this virus pro‐inflammatory cytokine storm has been called to have the main role. The right timing should be made for treatments. We proposed IL‐ 1 blocking by anakinra in seventeen COVID‐19 patients at high risk of worsening. Patients were assessed according to HScore, SOFA (Sequential Organ Failure Assessment Score = SOFA), MuLBSTA Score (multilobular infiltration, hypo‐lymphocytosis, bacterial coinfection, smoking history, hyper‐tension, and age), Brescia‐COVID respiratory severity scale (BCRSS). In our study, the mortality rate was 17.6%. Consequently, 1 (5.9%) patient was receiving low‐flow oxygen supply, 3 (17.6%) patients needed no longer oxygen supply and 10 (58.8%) patients were discharged from the hospital. According to the results of our study in the manner of general evaluation; we found that SOFA, MuLBSTA, and BCRSS scores were one step ahead according to HScore being insufficient to determine early phases of the disease. In our opinion, the prominent factors that emphasize the use of anakinra could be listed as comorbidity, risk, or presence of secondary infection, ongoing malignant disease. However, the other factors that enhance the use of anakinra in the situation of viremia also could be sorted as no response to full dose antivirals, antiviral side effects, or no success to antiviral treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists. Methods A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included. Results A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients. Conclusions The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.

Introduction: The presence of new coronavirus (SARS-CoV-2) in semen and the possibility of sexual transmission have become new subjects of curiosity. There is a discrepancy regarding this issue in the literature. The presence of SARS-CoV-2 in semen has been investigated in a limited number of studies, and mostly in recovering patients. We aimed to investigate the presence of SARS-CoV-2 RNA in semen of patients with a positive nasopharyngeal swab test for SARS-CoV-2 in the acute stage. Methods: We enrolled adult male patients who were hospitalized with confirmed SARS-COV-2 infection in the study. In addition to routine laboratory and radiological tests, semen sample was obtained from volunteers and transferred to the Turkish Public Health Institution, National Virology Laboratory. The samples were processed for the detection of SARS-CoV-2 RNA on the day of collection. Results: Sixteen patients were included in the study. The median age was 33.5 years (18–54). All but one had respiratory symptoms. None of the patients had a history or symptoms of urogenital disease. All semen samples were obtained during hospitalization and in the acute stage of the infection. The median time to obtain a semen sample after positive nasopharyngeal test was 1 day (0–7). All semen samples were detected as negative for SARS-CoV-2 PCR. Discussion/Conclusion: Although all semen samples were obtained in acute stage of the infection when the nasopharyngeal swab test was positive, we did not detect SARS-CoV-2 in semen. The results of our study support the thought that sexual transmission via semen does not have an important role in the person-to-person transmission of SARS-CoV-2. We think that our study will provide new information to fill the gap in the literature. [ABSTRACT FROM AUTHOR]

Subacute thyroiditis (SAT), is a self-limiting inflammatory disorder which is linked to a viral infection. A few cases of SAT were reported after Severe Acute Respiratory syndrome Coronavirus-2 (SARS-CoV-2) infection. We here reported a case of SAT that occurred two weeks after SARS-CoV-2 infection. A thirty-nine-year-old male with no comorbid diseases applied to our outpatient clinic with the complaints of sore throat, fatigue and subfebrile fever. He had a contact history of his wife who has a positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test. The nasopharyngeal swab was performed and his SARS-CoV-2 RT-PCR test was confirmed positive. He recovered from all symptoms in one week. On the second week of the first diagnosis, he developed neck pain, fatigue, muscle pains, palpitation and tremors. Because his thyroid palpation was painful and he was more symptomatic thyroid function tests were performed. Thyrotropin was suppressed (0.01 mIU/L), free triiodothyronine and free thyroxine levels were high as 11 ng/L and 3.72 ng/dL, respectively. His cervical ultrasound also revealed SAT. He was treated with prednisolone, ibuprofen and propranolol. Within one week, there was a progressive resolution of signs and symptoms. After the third week, his laboratory results returned to normal ranges. [ABSTRACT FROM AUTHOR]

Crimean Congo hemorrhagic fever (CCHF) is a viral zoonotic disease with high mortality rate. There are only a few studies on viral load in CCHF. In our study, we revealed the dynamics of viral load and its relationship with mortality in early phase of the disease. A total of 138 serum samples were collected from 23 patients. All patients had positive PCR for CCHF on admission. Serum samples were obtained daily from all patients for the first 6 days of hospitalization and stored at −80°C for viral load measurement. We found statistically significant difference between mean number of viremic serum samples of fatal and non‐fatal patients. Furthermore, non‐fatal cases' viral loads demonstrated statistically significant decreases over time; however, we could not observe a similar trend in viral loads of fatal cases. Limited number of studies on CCHF indicate that score of the contest between CCHF virus and immune system determines the survival in CCHF and viral load is found to be the most prognostic factor. In our study, we found that there is a notable decrease trend in viral loads of non‐fatal patients over time and this clearance of CCHF virus is significantly related with survival. [ABSTRACT FROM AUTHOR]

Objectives:Crimean Congo hemorrhagic fever (CCHF) is the second most common hemorrhagic fever worldwide. This study aimed to evaluate the oxidant–antioxidant balance of patients with CCHF by detecting dynamic thiol disulfide homeostasis (TDH), which is a novel oxidative stress marker, and other molecules, including paraoxonase (PON), arylesterase (ARES), ceruloplasmin (CLP), myeloperoxidase (MPO), and catalase. Methods:This retrospective, cross-sectional, controlled study, which involved patients with CCHF and healthy volunteers, measured dynamic TDH using a novel automated method developed by Erel. Results:We recruited 69 adult patients with CCHF (31 females, 38 males, median age 46 years). The case fatality rate was 1.49% (1/69). Increased disulfide/native thiol and disulfide/total thiol ratios, decreased total antioxidant status (TAS), and increased total oxidant status (TOS) were found in patients with CCHF. TAS, PON, and ARES values were found to be positively correlated with both native and total thiol levels, whereas TOS and CLP were negatively correlated with both, at a significant level. MPO activity was similar in both groups. Discussion:This is the first study in the literature to evaluate dynamic TDH in CCHF. TDH shifts to the oxidative side in patients with CCHF, leading to an increase in TOS. [ABSTRACT FROM AUTHOR]

Background Crimean Congo hemorrhagic fever (CCHF) is a fatal disease with a mortality rate of 5–30%. CCHF can be asymptomatic or it may progress with bleeding and cause mortality. Objectives To evaluate relation of viral load with mortality, clinical and laboratory findings in CCHF. Study design A total of 126 CCHF patients were included. Serum samples obtained from all patients on admission for measurement of viral load. Results In our study, mortality rate was 11.1%. The most important prognostic factor was viral load. Mean viral load was 8.3 × 10 7 copy/ml and 4.6 × 10 9 copy/ml in survived and dead patients, respectively ( p < 0.005). Probability of survival is found to be significantly reduced where AST >1130 U/l, ALT >490 U/l, CPK >505 U/l, LDH >980 U/l, platelet count <23 × 10 3 /l, creatinine >1.4 mg/dl, INR >1.3, d -dimer >7100 ng/dl, and viral load >1.03 × 10 8 copy/ml. Patients with 10 8 copy/ml or higher viral load had diarrhea, headache, unconsciousness, bleeding, and seizure significantly more frequently ( p < 0.05). WBC, hemoglobin, platelet counts were significantly lower whereas AST, ALT, CPK, LDH, creatinine levels, PT and aPTT time, d -dimer levels, and INR were found to be significantly higher in these group. Conclusions There are several severity criteria for prognosis of CCHF. In addition to these parameters, we introduce creatinine as a predictive factor for prognosis. Our study, which has the largest number of patients among studies that evaluate viral load on CCHF shows that viral load is the most effective parameter on mortality. [ABSTRACT FROM AUTHOR]

Summary Background A. baumannii is an important nosocomial pathogen associated with high mortality, morbidity and medical cost. Aim The aim of this study was to investigate risk factors for MDR A. baumannii bacteremia and also evaluate cost of hospitalization of these patients. Methods Study was conducted in Ankara Atatürk Training and Research Hospital. Patients who were hospitalized in ICU and diagnosed for nosocomial blood stream infection (BSI) between January 2007 and December 2010 were checked retrospectively. Patients with nosocomial BSI caused by multidrug resistant A. baumannii were compared with the patients who had BSI caused by other Gram-negative microorganisms in terms of risk factors, mortality and medical costs. Findings In multivariate analysis previous use of carbapenem, quinolone and metronidazole, and SAPS II score were found as independent risk factors. In case group; immunosupression, SAPS II score, and hospital stay until infection were independently associated with mortality in multivariate analysis. Conclusion Our results suggest that the occurrence of MDR A.baumannii bacteremia was related with the usage of the wide spectrum antibiotics, and mortality rates were increased in patients that high SAPS II scores, long term hospitalization. Infection control procedures and limited antibiotic usage are very important for prevent nosocomial infections. [ABSTRACT FROM AUTHOR]

Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonotic disease that is transmitted primarily through contact with ticks. Nosocomial cases and outbreaks of CCHF have been reported from many countries. Health care workers (HCWs) are at risk of exposure to CCHF. In our study, we evaluated seven HCWs' exposure to confirmed CCHF patients' infected blood and body fluids and prophylactic efficacy of the ribavirin on nosocomial transmission of CCHF retrospectively. Between 2007 and 2013, 150 CCHF cases were admitted to our clinic. During the follow-up of these patients, four doctors and three nurses had contact with infected blood and body fluids through needle stick injury, contact of skin and mucosal surfaces, and probable aerosolization. All of the index cases' diagnoses of CCHF were confirmed during the contact. Ribavirin prophylaxis was administered within 0.5-1 h in six out of seven cases. All of these cases' CCHF virus PCR results were negative. One physician had no contact with infected blood or body fluid, so ribavirin prophylaxis was not administered. The physician developed CCHF and diagnosis was confirmed. Although efficacy of ribavirin for prophylaxis is not clear and very few data exist on prophylactic usage of ribavirin, lack of clinical manifestations in our cases that were given ribavirin compared with the developed clinical manifestations in the physician may be explained by the prophylactic efficacy of the ribavirin. [ABSTRACT FROM AUTHOR]

Hydatid cyst is one of the five most diagnosed zoonotic diseases in the Mediterranean region. However, intramuscular localisation is very rare. It is reported that muscular involvement constitutes 1-5.4% of all Echinococcus infections. Here we would like to report an unusual case of hydatid cyst in the gluteus muscle, which had been treated with both surgical and medical treatment. [ABSTRACT FROM AUTHOR]

Aim: To analyze the risk factors of lamivudine treatment failure (LTF) for the long-term use in patients with low viral load (LVL). Material and Methods: In this multicenter study, 548 antiviral naïve noncirrhotic adult patients with LVL (for HBeAg+ patients HBV DNA <109 copies/ml and for HBeAg- patients HBV DNA <107 copies/ml) were enrolled. As a control group, 46 lamivudine-initiated patients with high viral load (HVL) were included. Primary outcome was switching to or adding on another antiviral drug as a consequence of primary nonresponse, partial response, viral breakthrough or adverse events. Secondary outcomes included LTF rates at 1, 2, 3, 4 and 5 years and LTF-related viral and host factors. Results: Among 594 patients, 294 had to change lamivudine at the follow-up. Primary nonresponse, partial response, viral breakthrough or adverse events frequencies were 6.8, 1.6, 64.5 and 0.1%, respectively. Five-year LTF rates were 61.3 and 84.2% in patients with LVL and HVL, respectively. Among patients with LVL, patients with <100,000 copies/ml and ≥100,000 copies/ml had 54.8 and 67.3% LTF rates at the end of the 5th year, respectively. Logistic regression analysis of risk factors showed HBeAg+, hepatic activity index, HBV DNA, virological response at 6 months and duration of follow-up were independent predictors for LTF (p values were 0.001, 0.008, 0.003, 0.020 and 0.003, respectively). Conclusion: Similar to patients with HVL, first-line lamivudine therapy is not efficient for long-term use in patients with LVL. LTF risk is so high even in the absence of worse predictive factors. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The first reactive arthritis case associated with COVID-19 Abbreviations ACE2 angiotensin-converting enzyme-2 anti-CCP antibodies to cyclic citrullinated peptide COVID-19 novel coronavirus disease 2019 NSAID nonsteroidal anti-inflammatory drug ReA reactive arthritis RF Rheumatoid factor SARS-CoV-2 novel coronavirus INTRODUCTION New type pneumonia, later termed the novel coronavirus disease 2019 (COVID-19) arose from Wuhan Province in China in December 2019, has quickly become a global public health emergency.1 The etiological agent was identified as a new type coronavirus, named as novel coronavirus (SARS-CoV-2).2 Outbreak has rapidly spread all over the world3 and the first confirmed COVID-19 patient in Turkey was reported on 11th March 2020.2 A syndrome of dysregulated and systemic immune overactivation described as a cytokine storm or hyperinflammatory syndrome may develop during of the course COVID-19.4 As a result, coagulation and inflammation can significantly affect disease progression.4,5 In this case, we report the first reactive arthritis associated with COVID-19 infection. Also, gastrointestinal manifestation was reported in approximately 12% of COVID-19 patients.7 Gastrointestinal system may serve as a secondary site for COVID-19 infection in relation to the expression of angiotensin-converting enzyme-2 in the gastrointestinal tract.8 ReA may be related to this involvement. [Extracted from the article]

Dear Editor, We read the letter to the editor by V. Wiwanitkit with the title "SARS-CoV-2 in semen" [[1]]. We think that even if severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is detected in a patient's semen sample, it is quite difficult to say that the transmission between partners has solely been through semen. [Extracted from the article]