Purpose: This study aimed to evaluate the effects of a supervised aerobic exercise training program on weight loss, functional capacity, quality of life(QoL) and depression level in patients with essential hypertension. Methods: This is a prospective study. Patients who chose the treatment type according to personal preferences were divided into two groups: Group 1(n:91) exercised for six weeks, five sessions per week under the supervision of a medical doctor in the aerobic exercise laboratory and group 2(n:47) declared to perform a walking in the free time, at least twice a week, but without supervision. Body weight, serum lipid levels, functional capacity, QoL, and depression level of all the participants were evaluated at the pre-treatment period and the post-treatment 6th week. Results: When the two groups were compared, a significant increase in the six-minute walk test(6MWT) distance and SF-36 subscales of physical function, role physical, physical component summary, vitality, role emotional and mental component summary in Group 1 at the post-treatment 6th week was found in Group 1. There was a significant reduction in the resting systolic blood pressure(SBP), weight, body mass index and Beck Depression Inventory scores between pre-treatment and post-treatment 6th week in Group 1. There was a significant increase in the METs, 6MWT, SF-36 subscales of physical function, role physical, physical component summary, vitality, role emotional and mental component summary scores between pre-treatment and post-treatment 6th week in Group 1. Conclusion: Supervised aerobic exercise training of 6 weeks duration is more effective than unsupervised aerobic exercise training for the functional capacity and QoL in patients with hypertension. Supervised aerobic exercise as antihypertensive lifestyle therapy should be recommended for patient compliance, absence of adverse incidents, and its positive impact on resting SBP, weight, functional capacity, QoL, and depression level in patients with hypertension.

Objective: In the present study, the importance of albumin level in severe pneumonia due to covid 19 was investigated. Design: This was a retrospective study. Setting:Emergency Department of Ankara City Hospital, between 1 september 2020 and 1 february May 2021. Subjects: Effective triage and early detection are very important for the control and treatment of coronavirus disease 2019. For this purpose the relation between hypoalbuminemia and other acute phase reactants was compared in severe pneumonia due to Covid-19. Main outcome measures: The data of 122 patients diagnosed with pneumonia due to Covid 19 and 60 healthy control group were retrospectively analyzed in statistical terms in computer medium. The cases were divided into 3 groups as Healthy Control Group, Intubated Group, and Non-Intubated Group. The lung tomography of patients diagnosed with Covid 19 pneumonia was examined one-by-one. The RT-PCR (Real-Time Polymerized Chance Reaction) test results were recorded from the system. The albumin, WBC (White Blood Cell), N/L (Neutrophil/Lymphocyte Ratio), CRP (C-Reactive Protein) levels, who are acute phase reactant levels, of the patients were compared with the Control Group. Also, the two groups who were intubated and not intubated were also compared. Results: When all the data were examined, it was found that the albumin levels were lower at statistically significant levels in all 3 study groups (p<0.01). The other acute phase reactants, N/L ratio and CRP levels were significantly higher (p<0.05). Hypoalbuminemia was found to be significantly lower as a result of the comparisons of the two groups that were intubated and not intubated (p=0.02), and no differences were detected in terms of other parameters (p>0.05). Conclusion: Serum albumin levels may be lower in severe Covid 19 pneumonia. Hypoalbuminemia can be a biomarker indicating the severity of the disease as an acute phase reactant.

Background Pharmacotherapies are widely used for smoking cessation. However, their effect on smoking cessation for people with alcohol dependence remains unclear. Objective This study aimed to explore the effects of pharmacotherapies on smoking cessation for people with alcohol dependence. Methods Five electronic databases were searched in January 2021 for randomized controlled trials (RCTs) reporting the use of pharmacotherapies to promote smoking cessation in people with alcohol dependence. The risk of bias was assessed using the Cochrane tool. RevMan version 5.3 was used to perform meta-analyses of the changes in smoking behavior, and the GRADE approach was used to assess the certainty of the evidence. Results Nine RCTs involving 908 smokers with alcohol dependence were identified. Eight RCTs were published in the United States, and one was from Canada. The risk of bias was rated as low in three studies and unclear in the remaining six. The results of the meta-analysis showed that, compared with the placebo group, Varenicline had a significant effect on short-term smoking cessation (three RCTs, OR = 6.27, 95% CI: [2.49, 15.78], p < 0.05, very low certainty). Naltrexone had no significant effect on smoking cessation in short-term or long-term observations (three RCTs, OR = 0.99, 95% CI: [0.54, 1.81], p = 0.97, moderate certainty), and Topiramate had no significant effect (two RCTs, OR = 1.56, 95% CI: [0.67, 3.46], p > 0.05, low certainty). Only one trial reported that Bupropion had no effect on smoking cessation. Conclusion Varenicline may have a positive effect on smoking cessation in people with alcohol dependence. However, Naltrexone, Topiramate, and Bupropion seem to have no clear effect on increasing smoking abstinence among drinkers. The small number of studies and the low certainty of evidence indicate that caution is required in interpreting the results.

Objective: The term ‘mild stroke’ is used to describe stroke patients with a NIHSS score of 0 to 6. There is still no clear decision regarding the application of iv recombinant tissue plasminogen activator (iv-tPA) to patients who is admitted with an acute ischemic stroke and is in the mild stroke category. In our study, we aimed to analyze the data of patients who applied to our stroke center with an acute mild stroke clinic and received iv-tPA treatment and their three-month follow-up. Methods: A total of 47 (age 69.1 ± 14.1, 28 female) mild stroke patients were included out of 350 patients receiving thrombolytic therapy. Intravenous thrombolysis was initiated with a maximum delay of 4.5 hours in all patients. Patients had a NIHS score less than 6. NIHSS scores immediately before starting thrombolytic therapy and scores 24 hours after treatment were recorded. Modified Rankin Scale scores (mRS) at admission, 1 and 3 months were recorded. Results: NIHSS scores of the patients who received tPA decreased significantly after the treatment (p = 0.001). The patients’ 1st and 3rd month mRS scores were statistically significantly decreased according to the mRS scores when they entered the treatment (p = 0.001). Conclusions: This study highlights the efficacy of iv-tPA in acute ischemic stroke patients with mild symptoms and demonstrates the low risk profile of this therapy.

In 2020, we had reported one of the few cases of trisomy 13 with ectrodactyly, a rare form of limb deformity. Herein, we report another newborn who suffered from trisomy 13 and ectrodactyly. The patient also possessed another unusual manifestation of trisomy 13, congenital diaphragmatic hernia, a life- threatening pathology.

Objectives One important group of people at higher risk from the COVID-19 pandemic are those with autoimmune conditions including rheumatoid arthritis/inflammatory bowel disease. To minimise infection risk, many people are now being switched from intravenous to subcutaneous biologics including biosimilars. A key question is how transition costs are viewed by clinicians. Design The survey was designed to understand the comparative economic issues related to the intravenous infusion vs subcutaneous biologic administration routes for infliximab. The survey focused on direct cost drivers/indirect cost drivers. Wider policy implications linked to the pandemic were also explored. Setting/Participants Semi structured telephone interviews were carried out with twenty key stakeholders across the NHS from clinical/pharmacy/commissioning roles. The interviews were undertaken virtually 5thApril-27thApril 2020 and included a semi-structured interview framework with questions across the two administration routes. Results From interview results a simple cost analysis was developed plus a qualitative analysis of reports on wider policy/patient impacts. Key findings included evidence of significant variation in infusion tariffs UK wide, with interviewees reporting that not all actual costs incurred are captured in published tariff costs. A cost analysis showed administration costs 50% that of infusion, with a most patients administering subcutaneous medicines themselves. Other indirect benefits to this route included less pressure on infusion unit waiting times and reduced risk of COVID-19 infection plus reduced patient costs. However, this was to some extent offset by increased pressure on home-care and community/primary care services. Conclusions Switching from infusion to subcutaneous routes is currently being driven by the COVID-19 pandemic in many services. A case for biologics (infusion vs subcutaneous) must be made on accurate real-world economic analysis. In an analysis of direct/indirect costs, excluding medicine acquisition costs, subcutaneous administration appears to be the more cost saving option for many patients even without the benefit of industry funded home-care.

Arrhythmia Induced Cardiomyopathy: What are Predictors of Myocardial Recovery?Acile Nahlawi BS, Marwan M. Refaat MDDepartment of Internal Medicine, Division of Cardiology, American University of Beirut Medical Center, Beirut, LebanonRunning Title: AIC and Predictors of Myocardial RecoveryDisclosures: NoneFunding: NoneKeywords: Cardiac Arrhythmias, Cardiovascular Diseases, Heart Diseases, Congestive Heart Failure, CardiomyopathyWords: 958 (excluding references)Correspondence:Marwan M. Refaat, MD, FACC, FAHA, FHRS, FASE, FESC, FACP, FRCPAssociate Professor of MedicineDirector, Cardiovascular Fellowship ProgramDepartment of Internal Medicine, Cardiovascular Medicine/Cardiac ElectrophysiologyDepartment of Biochemistry and Molecular GeneticsAmerican University of Beirut Faculty of Medicine and Medical CenterPO Box 11-0236, Riad El-Solh 1107 2020- Beirut, LebanonFax: +961-1-370814Clinic: +961-1-759616 or +961-1-355500 or +961-1-350000/+961-1-374374 Extension 5800Office: +961-1-350000/+961-1-374374 Extension 5353 or Extension 5366 (Direct)Email: mr48@aub.edu.lbCardiomyopathies cause a significant public health burden and improvement in sudden cardiac death risk stratification helped in decreasing mortality by improved pharmacotherapy as well as device implantations including implantable cardiac defibrillators and cardiac resynchronization therapy [1-4]. Arrhythmia induced cardiomyopathy (AIC) is a major cause of non-ischemic cardiomyopathy and heart failure (HF) worldwide [5]. It is characterized by an impairment of left ventricular systolic function secondary to high heart rate (tachycardia-induced), asynchrony (frequent premature ventricular contractions-induced or right ventricular pacing-induced) or an irregular rhythm (such as atrial fibrillation-induced) that serves as the trigger of AIC and this is mediated by calcium mishandling. The distinctive feature of AIC is the substantial improvement in left ventricular systolic function following arrhythmia suppression or elimination [5]. Atrial Fibrillation (AF) is concomitantly present with and potentially the cause of 10 to 50% of HF cases [6]. AIC is an important, commonly encountered and potentially reversible entity that is often under-recognized. The exact incidence and prevalence of AIC remains poorly defined in the literature [7]. In some studies, it was present in as high as 50% of patients with AF undergoing ablation, while it was reported to be present in 10% of patients with focal atrial tachycardia undergoing ablation [8]. In addition, very little attention, if any, is given to AIC in major trials on AF and HF, despite its significant implications on morbidity and mortality and the promising benefits of treatment [7]. Many aspects of AIC are yet to be understood. In fact, few studies limited by small sample size constitute our main source of knowledge on extent and predictors of ventricular recovery after treatment initiation in patients with AIC [9,10].In their multicenter retrospective study, Gopinathannair et al. aimed to assess the degree of recovery of the left ventricular systolic function after suppression/elimination of the underlying arrythmia and to evaluate factors influencing this response such as baseline patient and arrhythmia characteristics. The study sample comprised 243 patients from 3 different institutions whose charts were reviewed retrospectively (no recruitment timeframe was indicated). The patient characteristics studied included baseline left ventricular ejection fraction (LVEF), presence of structural heart disease (SHD) [ defined as significant coronary artery disease, prior myocardial infarction, hemodynamically significant valvular heart disease, or other structural cardiomyopathies] and medications used. As for the arrhythmia characteristics, they included arrhythmia duration and arrhythmia type. The authors used echocardiography as the imaging modality to determine extent of ventricular function recovery by comparing myocardial function before and after treatment of the culprit arrhythmia. The echocardiographic parameters that were assessed included LVEF, LV end-diastolic and end-systolic diameters, left atrial dimension, valvular abnormalities, right ventricular systolic pressures, and pulmonary arterial pressures.In contrast to reported literature on the topic, Gopinathannair et al. found that none of the studied patient and arrhythmia characteristics had a significant effect on the recovery of ventricular function. Their results showed that initiation of aggressive arrhythmia treatment is warranted in patients with suspected AIC, regardless of arrhythmia duration, arrhythmia type, severity of baseline LVEF, and underlying structural heart disease. This was concluded based on the consistent substantial improvement in LVEF after arrhythmia suppression/elimination, mainly through rhythm control, across all different subgroups. In fact, the extent of LVEF improvement was similar whether comparing the group with known arrhythmia duration [KN] to that with unknown arrhythmia duration [UKN] (21.2±9 % vs 19.4±11 %, p-value =0.16) or comparing the group with longest arrhythmia duration to the rest (21.5±7.5 % vs 21.0 ± 9.2%, p-value=0.77). On the other hand, greatest improvement was seen in the group with lowest initial LVEF (24±17 vs 19±7%; p-value <0.0001), making low index LVEF the only predictor of LVEF recovery after arrhythmia treatment in patients with AIC. However, the LVEF in these patients did not reach complete normalization; they had lower post-treatment LVEF compared to other groups (45±14 vs 54±8%; p<0.0001), a finding consistent with the available literature. Also similar to previous studies, the authors found that patients with PVCs experienced smaller extent of recovery compared to other arrhythmia types. The authors concluded by stressing the importance of suspecting AIC in patients having cardiomyopathy with a persistent arrhythmia and initiating aggressive arrhythmia treatment regardless of initial patient and arrhythmia characteristics.As for the limitations of the study by Gopinathannair et al., there are few to mention. First, the study had a retrospective design and therefore findings only serve to generate hypotheses that need further testing and validation. Second, there is a lack of a control group to exclude interference of confounding factors. Although the use of Angiotensin-Converting Enzyme inhibitors (ACEi)/ Angiotension receptor blockers (ARB) did not independently predict LVEF improvement in multivariate analysis, it could still be a confounder given the lower rates of ACEi/ARB use in the cohort. Third, the timeframe of the study and the period of follow-up were not clearly defined. Fourth, there is lack of blinding of echocardiographic analyses which can potentially lead to inter- and intra-observer variability. Finally, the sample population was not diverse as it consisted in its majority of Caucasians.The Gopinathannair et al. study demonstrated several points of strength. Among these are its multicenter nature and its relatively larger sample size compared to similar studies, giving its findings more weight. Moreover, the authors appropriately and clearly defined their inclusion and exclusion criteria. Furthermore, no funding was needed for the study which potentially frees it from direct or indirect influences on its design, execution and interpretation. Finally, the study has successfully improved our understanding of predictors of ventricular recovery in patients with AIC and showed that patients with AIC who had the longest duration of arrhythmia still had LV systolic function improvement with arrhythmia suppression/elimination. This study paves the way for prospective studies and randomized clinical trials to validate the generated hypotheses and corroborate the observational findings.

A document by Ruveyde AYDIN. Click on the document to view its contents.

Objective: The aim of this systematic review was to investigate the effectiveness of HIFE on physiologic and psychological functions in older adults aged ≥65 years. Methods: This systematic review was designed according to the PEDro scale. PubMed, Web of Science and Scopus databases were used for the systematic searching. Total 1340 studies were identified. The full texts of these studies were examined in respect of the study inclusion and exclusion criteria, and finally 9 studies met the criteria and were included for evaluation. Results: Physical functions and psychosocial functions were evaluated via questionnaires and tests. According to results of the included studies HIFE was effective in respect of the evaluated parameters. Conclusion: As a result of this systematic review HIFE is effective on physical functions and hemodynamic responses but the effect on psychosocial functions are controversially, at the same time there were no reports of negative effects.

Aim: This study aimed to assess uncertainty tolerances and determine the levels of stress, anxiety, depression, and somatization in healthcare workers who fight on the frontline, at the highest risk but seek the least help during the pandemic. Methodology: The data of this cross-sectional study was collected by online delivery of a short form of Health Anxiety Inventory, Patient Health Questionnaire, the Impact of Event Scale, and Demographic Information Form to 106 medical staff consisting of medical doctors and nurses. At the start of the Coronavirus outbreak in Turkey, convenient sampling was used because of the difficulty in reaching healthcare workers. The mean scores of the scales were compared with ANOVA between the study groups. In case of significant differences, Bonferroni posthoc analysis was used to compare the subgroups. Findings: A total of 106 healthcare workers consisted of three groups: the first group; 28 workers who were temporarily not working during data collection; 46 workers working with non-COVID 19 patients in a non-pandemic hospital; 32 subjects working with COVID 19 patients in a pandemic hospital. The working conditions, institution’s type where physicians work for, and whether physicians previously received psychological support showed significant differences between the groups. Conclusions: According to our study results, healthcare workers working with COVID 19 patients reported higher levels of psychological symptoms. This study is crucial to reveal the significant effects of working with COVID 19 patients on healthcare workers’ mental health, especially in the early period of the 2020 epidemic.

Periodic chest pain, with bloody pleural effusion, should raise the suspicion of pleural endometriosis as a well-known, but rare condition in clinical practice.

A 49-year-old woman presented to the emergency department with dyspnea, a respiratory rate of 26 times per minute and a room air oxygen saturation of 69% after nasal inhalation of heroin. A chest computed tomography angiogram (CTA) revealed diffuse ground-glass opacities in all five lung lobes representing hypersensitivity pneumonitis

Male infertility may be the result of some identifiable conditions (varicocele, cryptorchidism, hypogonadism, and genetic abnormalities), but there is no identified cause in 30-40% of infertile men. Studies show that the use of antioxidants has a beneficial effect on fertility, especially on sperm quality, and therefore recommended as a potentially effective treatment for male infertility. However, it is argued that this treatment is not based on sufficient evidence and has no effect on the rate of healthy pregnancy. Aim: In this study, two different antioxidant combinations with different doses and contents were evaluated in terms of their effect on sperm parameters. Materials and Methods: A total of 122 patients diagnosed with idiopathic infertility were enrolled in our multicenter study. The patients were divided into two different groups: The first group used Proxeed Plus sachets 2x1 and the second group used Carniact Duo tablets 2x1 for six months. The total semen volume, total sperm count and concentration, motile sperm count, and morphological findings of the patients were compared at the end of the six months. The mean age of the patients participating in the study was 30.8 ± 6.05 years. No significant difference was found between the two groups in terms of baseline sperm count. Results: There was a significant difference between the baseline and sixth-month values of the patients using both combinations. However, no significant statistical difference was found between the groups according to the sixth-month data. Conclusion: The combinations of both antioxidants had a positive effect on sperm parameters, and the use of different doses and contents had a similar effect. Keywords: Antioxidants, Infertility, Vitamins, Spermiogram,

OBJECTIVE The aim of this study is to describe our short-term outcomes using BioIntegral pulmonic conduit. METHODS Between August 2018 and September 2019, the BioIntegral pulmonic valved conduit was used for right ventricular outflow tract reconstruction in 48 patients. The data was retrospectively retrieved from the patient charts. RESULTS The median age at the operation was 36 months (IQR:18-62 months). The diagnoses were PA-VSD in 28 patients, absent pulmonary valve in four patients, truncus arteriosus in six patients, TGA-VSD-PS in five patients, conduit stenosis in three patients and LVOT obstruction requiring Ross operation in two patients. In the postoperative follow-up 15 patients out of 48 had high fever. Out of these, 12 patients had concomitantly elevated CRP levels. There were no patients with blood culture positivity. The median postoperative length of hospital stay was 14 days (IQR:8-21 days). The overall mortality was recorded in 2 patients (4 %), one died due to right ventricular failure and multiple organ failure and one died due to pulmonary embolism. The two patients who died were not among the 15 patients with fever. CONCLUSIONS There was high incidence of fever and adverse outcomes in the short-term postoperative follow-up of the patients in whom the BioIntegral pulmonic valved conduit was implanted. Caution is advisable in using these conduits until there is convincing evidence about the sterilisation and storage standards of these grafts.

Coronavirus disease (COVID-2019) causes respiratory and systemic disease, has led to a sudden epidemic that affects people of all ages. The presence of cardiovascular comorbidities is associated with a higher risk of death. Therefore, patients with congenital heart disease represent a high risk population. When respiratory failure develops and mechanical ventilation is not sufficient due to Covid 19, extracorporeal membrane oxygenation (ECMO) may use as a form of rescue therapy. In this article, we present a newborn who required ECMO support for acute respiratory failure in the early postoperative period due to coronavirus 2 (SARS-CoV-2) after the aortic arch repair and ventricular septal defect closure operation. To the best of our knowledge, this patient was the first neonate case of SARS-CoV-2 infection after congenital heart surgery and was the youngest patient to receive ECMO support.

Current knowledge on environmental distribution and taxon richness of free-living bacteria is mainly based on cultivation-independent investigations employing 16S rRNA gene sequencing methods. Yet, 16S rRNA genes are evolutionarily rather conserved, resulting in limited taxonomic and ecological resolutions provided by this marker. We used a faster evolving protein-encoding marker to reveal ecological patterns hidden within a single OTU defined by >99% 16S rRNA sequence similarity. The studied taxon, subcluster PnecC of the genus Polynucleobacter, represents a ubiquitous group of planktonic freshwater bacteria with cosmopolitan distribution, which is very frequently detected by diversity surveys of freshwater systems. Based on genome taxonomy and a large set of genome sequences, a sequence similarity threshold for delineation of species-like taxa could be established. In total, 600 species-like taxa were detected in 99 freshwater habitats scattered across three regions representing a latitudinal range of 3400 km (42°N to 71°N) and a pH gradient of 4.2 to 8.6. Besides the unexpectedly high richness, the increased taxonomic resolution revealed structuring of Polynucleobacter communities by a couple of macroecological trends, which was previously only demonstrated for phylogenetically much broader groups of bacteria. A unexpected pattern was the almost complete compositional separation of Polynucleobacter communities of Ca2+-rich and Ca2+-poor habitats, which strongly resembled the vicariance of plant species on silicate and limestone soils. The presented new cultivation-independent approach opened a window to an incredible, previously unseen diversity, and enables investigations aiming on deeper understanding of how environmental conditions shape bacterial communities and drive evolution of free-living bacteria.

COVID-19 can present with lymphopenia and extraordinary complex multi-organ pathologies that can trigger long-term sequela. Given that inflammasome products, like caspase-1, play a role in the pathophysiology of a number of co-morbid conditions, we investigated caspases across the spectrum of COVID-19 disease. We assessed transcriptional states of multiple caspases and using flow cytometry, the expression of active caspase-1 in blood cells from COVID-19 patients in acute and convalescent stages of disease. Non-COVID-19 subjects presenting with various co-morbid conditions served as controls. Single-cell RNA-seq data of immune cells from COVID-19 patients showed a distinct caspase expression pattern in T cells, neutrophils, dendritic cells and eosinophils compared to controls. Caspase-1 was upregulated in CD4+ T-cells from hospitalized COVID-19 patients compared to unexposed controls. Post-COVID-19 patients with lingering symptoms (long-haulers) also showed up-regulated caspase-1 activity in CD4+ T-cells that ex vivo was attenuated with a select pan-caspase inhibitor. We observed elevated caspase-3/7 levels in red blood cells from COVID-19 patients compared to controls that was reduced following caspase inhibition. Our preliminary results suggest an exuberant caspase response in COVID-19 that may facilitate immune-related pathological processes leading to severe outcomes. Further clinical correlations of caspase expression in different stages of COVID-19 will be needed. Pan-caspase inhibition could emerge as a therapeutic strategy to ameliorate or prevent severe COVID-19.

This systematic review evaluates the efficacy and safety of biologicals for chronic rhinosinusitis with nasal polyps (CRSwNP) compared to the standard of care. Pubmed, EMBASE and Cochrane Library were searched for RCTs. Critical and important CRSwNP-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. RCTs evaluated (dupilumab-2, omalizumab-4, mepolizumab-2, reslizumab-1) included 1236 adults, with follow-up 20-64 weeks. Dupilumab reduces the need for surgery (NFS) and oral corticosteroid (OCS) use (RR 0.28; 95%CI 0.20-0.39, moderate certainty) and improves with high certainty smell (mean difference (MD) +10.54; 95%CI +9.24 to +11.84) and quality of life (QoL) (MD -19.14; 95%CI -22.80 to -15.47), with fewer treatment-related adverse events (TAEs) (RR 0.95; 95%CI 0.89-1.02, moderate certainty). Omalizumab reduces NFS (RR 0.85; 95%CI 0.78 to 0.92, high certainty), decreases OCS use (RR 0.38; 95%CI 0.10-1.38, moderate certainty), improves with high certainty smell (MD +3.84; 95%CI +3.64 to +4.04) and QoL (MD -15.65; 95%CI -16.16 to -15.13), with increased TAE (RR 1.73; 95%CI 0.60-5.03, moderate certainty). There is low certainty for mepolizumab reducing NFS (RR 0.78; 95%CI 0.64 to 0.94) and improving QoL (MD -13.3; 95% CI -23.93 to -2.67) and smell (MD +0.7; 95%CI -0.48 to +1.88), with increased TAEs (RR 1.64; 95%CI 0.41-6.50). The evidence for reslizumab is very uncertain.

FDG-PET/CT is expensive but useful for diagnosing difficult cases of reactive arthritis. It can reveal enthesitis and arthritis, which are a feature of reactive arthritis.

This short note corrects minor mistakes in the original paper.

Aim: To analyze developing infections after living donor hepatectomy (LDH) in living liver donors (LLDs). Methods: Demographic and clinical charecteristics of 1106 LLDs were retrospectively analysed in terms of whether postoperative infection development. Therefore, LLDs were divided into two group: with (n=190) and without (n=916) antimicrobial agent use. Results: The median age was 29.5 (min-max: 18-55). A total of 257 (23.2%) infection attacks (min-max: 1-8) was developed in 190 (17.2%) LLDs. The patients with infection that were longer intensive care unit (ICU) and hospital stays, higher hospital admissions, emergency transplantation, invasive procedures for ERCP, PTC biloma and abscess drainage, and the presences of relaparatomies and transcystic catheters. Infection attacks derived from a 58.3% hepatobiliary system, 13.2% urinary system, 6.6% surgical site and 5.8% respiratory system. The most common onset symptoms were fever, abdominal pain, nausea and vomiting. A total of 125 positive results was detected from 77 patients with culture positivity. The most detected microorganisms from the cultures taken are Extended-Spectrum β-lactamases (ESBL) producing Klebsiella pneumonia (16.8%) and Escherichia coli (16%), Methicillin-Resistant Staphylococcus aureus [(MRSA) (9.6%)], Methicillin-susceptible Staphylococcus aureus [(MSSA (9.6%)] and Pseudomonas aeruginosae (8.8%), respectively. The average number of ICU hospitalization days was 3±2 (min 1-max 30, IQR:1) and hospitalization days was 14±12 (min 3-max 138, IQR: 8). All infection attacks were successfully treated. No patients died due to infection or another surgical complication. Conclusion: Infections commonly observed infected biloma, cholangitis and abscess arising from the biliary system and other nosocomial infections are the feared complications in LLDs. These infections should be managed multidisciplinary without delay and carefully.

Background: Group B streptococcus (GBS), also name as Streptococcus agalactiae, is a gram-positive bacterium know for it capacity to colonises the vaginal and rectal areas of the mother and is a leading cause of neonatal mortality and morbidity. This study aimed at determining the prevalence, associated risk factors and antimicrobial susceptibility of GBS colonization among pregnant women attending antenatal care at Dschang District Hospital. Methods: This hospital-base cross-sectional study targeted pregnant women population attending hospitals for routine prenatal testing using a multistage sampling method. Pregnant women at 23.46 ± 6.44 weeks gestation completed a questionnaire and vaginal swabs were obtained for GBS analysis. Data were analysed using chi-squared (χ2) test or the Fisher’s exact test when appropriate and the multivariable logistic regression models. Results: The colonisation rate of GBS among pregnant women was 8.69%. Induce abortion (odds ratio [CI] = 3.09, 95% [1.56-6.21]), Spontaneaous abortions (OR= 2.82, 95% CI 1.14-7.29), Stillborn (OR [CI] = 7.75, 95% [2.61-21.71]), Fever (OR [CI] = 0.37, 95% [0.19-0.71]) and anemia (OR [CI] = 0.22, 95% [0.12-0.43]) were found to be influencing factors associated with GBS colonisation. Conclusion: Our findings suggest that none of the studied factors were significantly associated with GBS colonisation. Further longitudinal research is needed to establish the causal relationship and its biological mechanisms. Keys words: Group B Streptococcus, Prevalence, Risk Factors, Antimicrobial Susceptibility, Pregnant Women

Purpose: Clinical treatment of gastrointestinal neoplasms in patients with severe coronary stenosis is difficult, and it remains controversial to perform staged or simultaneous surgeries. The purpose of this study was to retrospectively analyze the feasibility and indications for simultaneous gastrointestinal tumor resection and off-pump coronary artery bypass (OPCAB) graft surgery. Methods: Data collected from a total of five patients, including three patients with gastric cancer and two patients with colorectal cancer, who underwent simultaneous radical cancer resection and OPCAB between September 2010 and October 2019, were retrospectively analyzed. Among these patients, one had an incomplete colonic obstruction. All patients had severe coronary stenosis, and one experienced acute heart failure before surgery. OPCAB was performed first, followed by the radical cancer resection. Results: All five patients were discharged from hospital without perioperative death, major cardiovascular events or anastomotic leakage. The mean postoperative hospital stay was 9.4 days. One patient experienced slight gastrointestinal bleeding after surgery, which improved with conservative treatment. After a mean follow-up of 39 months, two patients with gastric cancer died from tumor metastasis at 28 months and 37 months, while the remaining three patients did not have tumor recurrence or metastasis. None of the patients experienced myocardial ischemia. Conclusion: It is safe and feasible to perform simultaneous OPCAB and gastrointestinal surgeries on the premise of strictly controlling the indications for patients with gastrointestinal tumors complicated with severe coronary artery stenosis.

Using a household and plot-level survey conducted in 2016/17 in ten districts of Ethiopia, this study explores whether there is a difference in farmers’ adoption of sustainable land management (SLM) practices between their rainfed and irrigated plots. The paper also investigates the varying influence of different types of irrigation water management systems and associated irrigation technologies on the adoption of SLM practices in irrigated plots. Our findings show only a small difference in the average number of SLM practices between rainfed and irrigated plots, even though significant differences are observed between many of the practices applied individually among these plots. The econometric estimation shows that the role of the combined effect of irrigation water management system and irrigation technology on adoption of SLM practices is quite varied and very significant. The evidence highlights that farmers adopt more SLM practices in their plots with pump irrigation compared to those plots where gravity irrigation is applied. This finding implies that pump irrigation systems enhance complementarities with SLM practices. Furthermore, the results indicate that the type of irrigation water management and the technology applied could play an important role in restoring degraded lands and maintaining soil fertility, even when farmers’ adoption of irrigation were not explicitly triggered by concerns for soil health.