Introduction: In our study, we aimed to evaluate the epidemiological features of brucellosis and the efficacy of different treatment options in patients with various organ involvements. Methodology: Patients diagnosed with brucellosis and treated in two different centers between 2009 and 2019 were retrospectively screened and evaluated regarding epidemiological and clinical features, laboratory findings, and treatment responses. Results: The study included 297 complete-data patients (76% of rural patients were farmers). Farming (76%) and raw dairy (69%) were the main transmission methods. Most patients (98.6%) had positive tube agglutination tests. Ninety-two patients' blood and bodily fluid cultures grew Brucella spp. The incidence of leukopenia was 18.8%, thrombocytopenia 10.7%, anemia 34.3%, and pancytopenia 4.3%. Doxycycline and rifampicin were the major treatments, with streptomycin utilized in osteoarticular patients. Pregnant women with neurobrucellosis took ceftriaxone and trimethoprim-sulfamethoxazole. After one year, 7.1% of patients relapsed. Doxycycline + streptomycin and doxycycline + rifampicin had similar relapse rates (p = 0.799). The double- and triple-antibiotic groups had identical recurrence rates (p = 0.252). Conclusions: In uncomplicated brucellosis cases doxycycline + streptomycin and doxycycline + rifampicin treatments were equally effective. Again, there is no statistical difference in relapse development rates between double and triple combination treatments in uncomplicated brucellosis cases. Relapsed patients generally miss follow-ups, interrupt therapy, have osteoarticular involvement, and get short-term treatment. Patients with focused participation should be thoroughly checked at diagnosis and medicine, and treatment should be lengthy to prevent relapses.

Background/Objectives: Postoperative early hypocalcemia (PEH) is a key postoperative issue after parathyroidectomy in primary hyperparathyroidism. It often leads to long-lasting hypocalcemia, requiring more calcium and active vitamin D supplements. This study aimed to determine whether the extent of intraoperative parathyroid hormone (PTH) decline, measured 15 min after parathyroid tumor excision, could serve as a reliable intraoperative rule-out marker for PEH. Methods: We conducted a retrospective review of 88 adult patients who underwent surgical intervention for a solitary parathyroid tumor at a single institution. Postoperative early hypocalcemia (PEH) was defined as a total serum calcium level <8.5 mg/dL within the postoperative 6th hour or on postoperative day 1, requiring clinical calcium supplementation (oral and/or intravenous), with active vitamin D when appropriate. The percentage decrease in PTH at 15 min post-excision was calculated using morning-of-surgery preoperative PTH values alongside the 15-min post-excision levels. Additional variables assessed included preoperative alkaline phosphatase (ALP), parathyroid tumor weight, and serum concentrations of calcium, phosphate, magnesium, and 25-hydroxyvitamin D. Predictive factors were identified by logistic regression, and the diagnostic accuracy of the 15-min PTH decline was evaluated using receiver operating characteristic (ROC) curve analysis, optimizing cutoff selection with Youden’s index. Odds ratios were standardized per 10-unit increments for ALP and parathyroid tumor weight for interpretability. Results: Of the studied cohort, 10 patients (11.4%) developed PEH. The intraoperative 15-min PTH decline was notably greater in those who developed PEH compared to those who did not (81.2 ± 4.4% vs. 69.9 ± 8.3%; p < 0.001). Univariate logistic regression showed a significant association between the 15-min PTH decline and PEH (OR 1.22 per 1% increment; 95% CI 1.08–1.38). That said, when we added ALP and parathyroid tumor weight to the multivariate models, PTH decline no longer predicted independently. In contrast, ALP (OR 3.11 per 10 U/L; 95% CI 1.34–7.93; p = 0.011) and parathyroid tumor weight (OR 1.22 per 10 mg; 95% CI 1.10–1.48; p = 0.004) stayed significant. Thus, the incremental prognostic contribution of the 15-min PTH decline beyond ALP and parathyroid tumor weight appears limited. The ROC curve for the 15-min PTH decline produced an AUC of 0.883, with an optimal cutoff of 75% providing 100% sensitivity and 74.4% specificity. No patients with a PTH decline below 75% developed PEH. Conclusions: Preoperative ALP and parathyroid tumor weight showed the strongest independent associations with PEH following parathyroid tumor surgery. An intraoperative PTH decline of less than 75% at 15 min may serve as a practical rule-out tool for PEH, although further validation in larger patient populations is warranted.

Objectives: Studies have shown that fibrinolysis activity is insufficient in COVID-19 patients. Plasminogen activator inhibitor-1 (PAI-1) is an important antifibrinolytic molecule that plays a key role in the fibrinolytic system. In our study; we aimed to evaluate serum PAI-1 and other biochemical parameters of COVID-19 patients in terms of disease course and mortality. Methods: A total of 40 COVID-19 patients were hospitalized in the service and intensive care unit (ICU) of our hospital from October to December 2020 and 20 healthy volunteers were included in our study. The patients were grouped as those who transferred to the ICU from the service and transferred to service from the ICU. The first and second values of the same patients in both the service and the ICU were analyzed by SPSS. Results: The PAI-1 levels of the patients in the ICU were significantly higher than the levels of the same patients in the service and the healthy control group (p<0.001). IL-6, ferritin, and D-dimer levels in the ICU of the same patients were significantly higher than the levels of service and healthy control group (p<0.001). A positive correlation was found between initial serum PAI-1 and D-dimer levels in patients hospitalized in the service (p=0.039) and initial serum ferritin and IL-6 levels in the ICU (p=0.031). Conclusions: In our study, we found that PAI-1 levels increased significantly with the increase in mortality in COVID-19 patients.

Objectives: The effectiveness of the Luer-Lok™ Access Device (LL) with the intravenous catheter (IVC) on sample rejections, which is used to prevent primarily hemolysis in the emergency department (ED), clinics, and intensive care units (ICU), was examined. Methods: A total of 491.850 samples of eight months from Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital were investigated retrospectively. Inpatient, intensive care unit and emergency department samples were included in the study. Pre- (BLL) and post-Luer Lok (ALL) rejection of the samples analyzed. In the BLL period, 3,463 rejection samples out of 253,818 (1.36%) in the September-December period of 2020; in the ALL period, 1819 rejected samples from 238,032 (0.76%) in January-April 2021 were analyzed for all reasons. Results: It was determined that the use of LL significantly reduced all-cause sample rejections. In addition, a significant decrease was observed in the rates of hemolysis and clot-related rejection thanks to LL. Conclusions: According to our study data, in patients with IVC with the LL device, the pressure brought by the syringe is mainly avoided, and reliable blood collection is achieved, similar to the routine vacutainer blood collection apparatus, and hemolysis- and clot-related sample rejections are largely prevented.

Amaç: Polikistik over sendromu (PKOS), farklı fenotipik özelliklere sahip, kadınlarda en sık görülen endokrin bozukluk olan ve anovulatuar infertilitenin önde gelen nedeni olan çok faktörlü bir hastalıktır. Kisspeptinin, G proteinine bağlı reseptörünü hipotalamik-hipofiz-gonadal eksenine sinyal göndererek üreme hormonu üretimini düzenlemede çok önemli bir işleve sahip olduğu kabul edilmektedir. PKOS hastalarında yüksek kisspeptin seviyeleri bulunmuştur, ancak diğer araştırmalar bunun tersini göstermektedir. Çalışmamız bu konudaki hasta popülasyonu verilerimizi tartışarak bilimsel literatüre katkı sağlamayı amaçlamaktadır. Gereç ve Yöntem: Çalışmaya PKOS tanılı 42 kadın (ortalama yaş: 22.1±3.9) ve 39 sağlıklı kadın (ortalama yaş: 21.3±2.6) dahil edildi. Adetin üçüncü gününde alınan kan örneklerinden Kisspeptin ve rutin laboratuvar testleri incelendi. Ayrıca boy, kilo, homeostatik model değerlendirmesi-insülin direnci (HOMA-IR), vücut kitle indeksi (BMI), yaş, hirsutizm, bel çevresi, sigara kullanımı ve adet düzensizliği verileri de kaydedildi. Gruplar arasında, PKOS hastalarında ve tüm bireylerde karşılaştırma ve korelasyon analizleri yapıldı. Bulgular: Kisspeptin düzeyleri PKOS hastaları ile sağlıklı kadınlar arasında farklılık göstermedi (p=0.086). PKOS'lu hastaların kilosu, BMI, serbest tiroksin, luteinize edici hormon, insülin, hemoglobin A1c, platelet ve HOMA-IR değerleri daha yüksekti. Kisspeptin ve tiroid stimüle edici hormon tüm bireylerde korelasyon gösterirken, kisspeptin ve progesteron PKOS hastalarında korelasyon gösterdi. Sonuç: Literatürün aksine PKOS hastalarında kisspeptin düzeyleri sağlıklı kadınlardan farklı değildi. Hipotalamik veya yumurtalık kaynaklı PKOS alt tipleri, PKOS hastaları ile sağlıklı kadınlar arasında fark göstermeyen kisspeptin düzeylerini açıklayabilir. Konunun tamamen aydınlatılması için daha fazla araştırmaya ihtiyaç vardır.