THE RELATIONSHIP BETWEEN CRIMEAN-CONGO HEMORRHAGIC FEVER AND CLIMATE: DOES CLIMATE AFFECT THE NUMBER OF PATIENTS?

- Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonosis. The incidence of zoonotic diseases has been shown to be affected by climatic factors. In this study, we evaluated patients endemic to the CCHF region and examined the relationship between the number of patients and climatic properties of the region where they lived. The study included 548 CCHF patients. Along with the patient demographic and clinical characteristics, we recorded temperature, humidity and precipitation in the places where they lived at the time of their admission to the hospital. In addition to temperature, humidity and precipitation at the time of patient admission, these values were assessed at one month and three months prior to admission. The relationship between the number of patients and the above-mentioned values was examined. Humidity at the time of and one month prior to hospital admission, and precipitation three months prior to hospital admission were found to affect the number of patients admitted to the hospital for CCHF. In conclusion, climate appeared to affect the number of CCHF patients. We believe that the number of patients presenting to the hospital with CCHF could be predicted by taking into account climatic properties of the places where CCHF has been recorded, along with undertaking necessary measures.

Brucellosis in Patients with Crimean-Congo Hemorrhagic Fever.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is a fatal zoonotic viral disease caused by infection with a tick-borne virus of the genus Nairovirus. In this study, we investigated the incidence of brucellosis in patients diagnosed with CCHF. METHODS: Overall, 169 patients hospitalized with an initial diagnosis of CCHF were included in 2011 in Tokat/Turkey. Immunoglobulin M (IgM) antibodies and/or PCR results were used in the laboratory diagnosis of CCHF, while plate and standard tube agglutination (STA) tests were used to diagnose brucellosis. RESULTS: Overall, 120 patients (79%) with positive PCR tests were diagnosed with CCHF. Five (4.16%) were also diagnosed with brucellosis based on the positive plate and STA test results. Four patients (2.36%) had negative CCHF PCR and positive STA test results. CONCLUSION: Brucellosis and CCHF can mimic each other and that all patients with CCHF or brucellosis should be screened for both conditions.

Suppression of bromodomain-containing protein 4 by shRNA: A new approach for cancer treatment.

PURPOSE: MYC is a transcription factor coding gene that is believed to control 15% of the genes in the entire human genome. The central role of c-MYC in cancer pathogenesis makes it a major therapeutic target in field of anticancer agent development. METHODS: We targeted the acetyl-lysine binding modules or bromodomains, which are associated with c-MYC transcriptional activation. RESULTS: Sequence specific inhibition of BET bromodomains with small hairpin RNAs (shRNAs) resulted in cessation of cellular proliferation in different cancer cell lines. Unlike previous studies on inhibition of bromodomains with selective small-molecule inhibitors, our study revealed the significant role of BET bromodomains in solid tumours and also highlighted the ease of RNA interference (RNAi) methodology for inhibition of bromodomain translation. CONCLUSION: The degree of influence of BET bromodomain inhibition on proliferation in five cancer cell lines established it as the major target in malignancies characterized by activation of c-MYC.

Thorax CT findings in patients with Crimean-Congo hemorrhagic fever (CCHF).

PURPOSE: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease with high mortality. The agent causing CCHF is a Nairovirus. The virus is typically transmitted to humans through tick bites. CCHF is a life-threatening disease observed endemically over a wide geographical regions in the world and a little known about pulmonary findings in CCHF patients. METHODS: The patients that were admitted and diagnosed with CCHF between April 2010 and September 2015 were examined. Patients' medical records were then evaluated retrospectively. Patients who underwent thorax CT evaluation based on the clinical findings at the time of admission and/or during the hospital stay were included in the study. Patients' laboratory test results and thorax CT findings for respiratory assessment along with demographic characteristics. RESULTS: Forty patients diagnosed with CCHF that underwent thorax CT based on their indications were included in the study. Twenty-seven patients (62.5 %) were male with a mean age of 55.22 ± 19.84 years. According to these results, the three most common thorax CT findings were parenchymal infiltration [32 patients (80 %)], pleural effusion [31 patients (77.5 %)], and alveolar infiltration [28 patients (70 %)]. Moreover, we determined that the most frequently seen radiological findings often occurred bilaterally. CONCLUSIONS: There is still not enough information regarding this life-threatening disease. We also would like to emphasize that both direct radiography and thorax CT are highly successful in detecting frequently encountered radiological findings such as pleural effusion, alveolar hemorrhage, and parenchymal infiltration that indicate pulmonary involvement.

Does Crimean-Congo Hemorrhagic Fever Cause a Vasculitic Reaction with Pulmonary Artery Enlargement and Acute Pulmonary Hypertension?

PURPOSE: Crimean-Congo hemorrhagic fever (CCHF) is a viral tick-borne illness. Although its etiopathogenesis is not clearly understood, it is known to be a Nairovirus. We aimed to examine the viral effects of intense systemic inflammation and vascular damage on the pulmonary vascular beds and lung tissues. METHODS: A total of 45 patients who were diagnosed with CCHF were considered for this retrospective study. In this patient group, those whose lungs had been visualized via thoracic computer tomography (CT) were entered into the study. Diameters of the pulmonary trunk, main pulmonary arteries, atria, and ventricles were measured. Study group measurements were compared with the control group, which included patients with normal thoracic CT. RESULTS: Overall, 90 patients were enrolled in the study, with 45 patients in the study group and 45 in the control group. In the study group, the man-to-woman balance was 3/2. The average age in the study group was 54.07 ± 17.91 years. In comparing the average diameters of pulmonary arteries in the study and control groups, the study group's average pulmonary artery diameter was significantly larger than the control group (p < 0.001). CONCLUSIONS: The increase in diameters of the pulmonary trunks and main pulmonary arteries due to CCHF was first shown in this current study. Moreover, due to our findings, it should be noted that with the rise in pulmonary artery diameter in CCHF, pulmonary hypertension can appear acutely, and this condition can be significantly alter clinical course and follow-up of the viral illness.

Re-evaluation of 400 Crimean-Congo hemorrhagic fever cases in an endemic area: is ribavirin treatment suitable?

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease, seen in various regions around the world, leading to death following a clinical syndrome of hemorrhagic fever. METHODS: This trial was conducted in Tokat State Hospital that is located in an endemic area. Four hundred patients referring to hospital between 2007 and 2009 and diagnosed as having CCHF with RT-PCR were enrolled in this trial. Ribavirin was not administered to any patient. Epidemiological, clinical, and laboratory findings of CCHF and factors affecting mortality were evaluated. RESULTS: Twenty patients (5%) died and 380 patients recovered (95%). It was found that mean age, white blood cells (WBC), active tromboplastine time (aPTT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values were significantly higher in patients who died, as compared with recovered cases and the difference was significant. Platelet values were significantly lower in patients who died, as compared with recovered cases. CONCLUSIONS: Age, male gender, high levels of ALT, AST, WBC aPTT values, platelet levels, and decrease in these values during follow-up are indicative of a poor prognosis. Use of ribavirin is not required in treatment of CCHF.

Cyclosporiasis associated with diarrhoea in an immunocompetent patient in Turkey.

Cyclospora cayetanensis, the parasitic agent responsible for human cyclosporiasis, is an emerging worldwide cause of diarrhoea in immunocompetent people as well as in immunocompromised patients, such as those with AIDS. Reported here is the case of a 30-year-old Turkish woman, a lawyer, who was admitted to hospital in July 2002 with complaints of watery diarrhoea, anorexia, nausea, vomiting, abdominal pain and weight loss over a period of 1 week. Cyclospora sp. oocysts were determined by using modified Kinyoun's acid-fast stain. The patient was treated with trimethoprim/sulfamethoxazole (160/800 mg) b.i.d. for 7 days. This report is the first example of autochthonous cyclosporiasis in an immunocompetent patient in Turkey.