A new perspective to determine the severity of cases with Crimean-Congo hemorrhagic fever.

Background & objectives: We have established a severity grading score (SGS) system for predicting the fatality in Crimean-Congo hemorrhagic fever (CCHF) for the first time. Methods: This SGS has been set up by using several variables which were assumed to be associated with mortality according to the literature and also were considered to have clinical importance. Results: In all, 237 patients who had symptoms of CCHF for <5 days were included. The patients were grouped into three categories according to the mortality risk by using SGS as follows : low or no risk, intermediate and high risk groups. A SGS <5 showed no association with mortality (there were 158 cases in this group and all survived). This group constituted 66.7% of all the patients with CCHF. A SGS 6–10 showed moderate risk of mortality (10%) and seven out of 70 patients in this group died. SGS >11 means high risk for mortality (67%) and six out of 9 patients in this group died (p = 0.001). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for >11 points of SGS were 67, 100, 98, 100, and 98%, respectively. Conclusions: This scoring system may help the clinicians to decide which patient to refer to a tertiary step hospital which may also decrease the cost and improve the functionality of healthcare staff.

Delayed habituation in Behcet's disease.

Background: The autonomic nervous system in Behcet's patients may be affected due to various reasons. This entity may be detected with the measurement of the electrodermal activities, heart rate variability and pupillometric methods. Habituation is one of the implicit forms of learning and memory and the loss of habituation can reveal pathological changes in the synaptic regions. Aim: To determine whether there is a functional decrease in the synaptic effectiveness (habituation) of the pathways to sympathetic neurons that had been repeatedly activated in Behcet's. Materials and Methods: Twelve patients with Behcet's disease and 12 healthy controls were included in the study. Sympathetic skin potential (SSP) records were taken at normal room temperature in a quiet place within a Faraday cage. Sixteen square wave single shock impulses (duration: 1200 ms, strength: 5 mA) were applied on each case. Results: After the 1 st stimulus, the SSP amplitudes were lower in the patients compared to the controls ( P < 0.001, t value = 7.69). There was no significant differences among the SSP amplitudes after the 13 th impulse in the patients ( P> 0.05). Whereas there was no significant differences among the SSP amplitudes after the 9 th impulse in the controls ( P> 0.05). The habituation rate of the SSP after consecutive impulses was slowest in the patients compared to controls ( P < 0.001, t value = 12.39). Conclusions: There is a delayed habituation in Behcet's disease and that may due to pathologic changes with vasculitis through their peripheral nerves.

changing epidemiological trends for carcinoma of the lung in Turkey

To compare epidemiological parameters for lung cancer in the last 2 decades 1986-1995 versus 1996-2005. Data on demographic characteristics, and histological subtype of lung cancer patients were retrospectively collected by a chart review in Cumhuriyet University Hospital, Sivas, Turkey for the period of 1993-2005. All other full-text papers that report epidemiological data for lung cancer in Turkey were also searched for meta-analysis. A total of 25,604 patients were analyzed in the last 2 decades. The mean age at the time of diagnosis was 59.4 years, and 92.5% of the patients were males. In the last decade, the rate of squamous cell carcinoma decreased from 61-50%, however, the rate of small cell carcinoma increased from 19-24%, and the rate of adenocarcinoma from 20-26%. There was a shift in the male/female ratio in Turkey. The rate of squamous cell carcinoma decreased, however, small cell carcinoma and adenocarcinoma increased progressively